RESUMEN
The objective of the study was to determine whether neoadjuvant prednisone therapy affects histological features of cutaneous and subcutaneous mast cell tumors. Twenty-eight dogs with a treatment naïve > 1-cm diameter mast cell tumor (MCT) were randomly assigned (Random number generator; Random.org, Dublin, Ireland) in a blinded fashion to receive either prednisone or placebo (Quality Food Center Pharmacy, Kirkland, Washington, USA). Volumes of mast cell tumors were calculated before incisional and excisional biopsies. Following incisional biopsy, patients received either prednisone (1 mg/kg body weight) daily or a placebo for 7 to 14 days leading up to excisional biopsy. Tumor grade for cutaneous MCT, and mitotic count and atypia for all tumors were reported. Perioperative treatment with prednisone had no significant effect on tumor grade, atypia, or mitotic count. Tumor volume was significantly decreased with prednisone treatment. The use of neoadjuvant prednisone to decrease MCT volume in order to facilitate tumor excision, can be considered without significant concern for change of tumor histologic features in the common population of low- to intermediate-grade MCT.
Effet de la prednisone sur les caractéristiques histologiques et macroscopiques des mastocytomes canins. L'objectif de la présente étude était de déterminer si une thérapie néoadjuvante avec de la prednisone affecte les caractéristiques histologiques des mastocytomes cutanés et sous-cutanés. Vingt-huit chiens avec un mastocytome (MCT) ayant un diamètre > 1 cm avant le traitement furent répartis de manière aléatoire (Random number generator; Random.org, Dublin, Irlande) à l'aveugle pour recevoir soit de la prednisone ou un placebo (Quality Food Center Phamacy, Kirkland, Washington, USA). Les volumes des MCT furent calculés avant les biopsies d'incision et d'excision. À la suite des biopsies d'incision, les patients reçurent soit de la prednisone (1 mg/kg de poids corporel) quotidiennement ou un placebo pour 7 à 14 jours menant à la biopsie d'excision. Le grade des tumeurs pour les MCT cutanés, ainsi que le dénombrement mitotique et l'atypie pour toutes les tumeurs furent rapportés. Le traitement préopératoire avec de la prednisone n'a pas eu d'effet significatif sur le grade des tumeurs, l'atypie ou le dénombrement mitotique. Le volume des tumeurs était réduit significativement avec le traitement à la prednisone. L'utilisation néoadjuvant de prednisone afin de diminuer le volume des MCT dans le but de faciliter l'excision des tumeurs peut être considérée sans préoccupation significative pour des changements dans les caractéristiques histologiques des populations habituelles de MCT de grade bas à intermédiaire.(Traduit par Dr Serge Messier).
Asunto(s)
Enfermedades de los Perros , Neoplasias Cutáneas , Animales , Enfermedades de los Perros/tratamiento farmacológico , Perros , Prednisona/uso terapéutico , Piel , Neoplasias Cutáneas/tratamiento farmacológico , Neoplasias Cutáneas/veterinariaRESUMEN
OBJECTIVE To compare duration of surgery, recurrence rate, and survival time between cats with idiopathic chylothorax treated with thoracic duct ligation (TDL) plus subphrenic pericardiectomy (SPC) and those treated with TDL, SPC, and cisterna chyli ablation (CCA). DESIGN Retrospective case series with nested cohort study. ANIMALS 22 client-owned cats surgically treated for idiopathic chylothorax from 2009 through 2014. PROCEDURES Patient and surgery data were collected from the medical records. Recurrence of chylothorax and survival time were assessed by medical record review and client interview. Comparisons were made between cats treated with TDL plus SPC (TDL-SPC group) and those treated with TDL, SPC, and CCA (TDL-SPC-CCA group). RESULTS 15 cats were treated with TDL plus SPC, and 7 were treated with TDL, SPC, and CCA. Median duration of surgery was significantly briefer for the TDL-SPC group (80 minutes; range, 55 to 175 minutes) than for the TDL-SPC-CCA group (125 minutes; range, 105 to 205 minutes). Five cats (2 in the TDL-SPC group and 3 in the TDL-SPC-CCA group) had persistent pleural effusion 4 weeks after surgery. Chylothorax recurred in 2 cats (1/group). Median survival time in the TDL-SPC group was 774 days (range, 3 to 2,844 days) and in the TDL-SPC-CCA group was 380 days (range, 11 to 815 days); these values did not differ significantly. CONCLUSIONS AND CLINICAL RELEVANCE Addition of CCA to the surgical treatment approach for cats with idiopathic chylothorax was associated with a significantly longer duration of surgery with no better outcome than achieved with TDL plus SPC alone.