Clinical outcome in dogs with cutaneous mast cell tumors treated with neoadjuvant prednisolone and surgical excision

Autor: Hui-Ju Wang, 王慧如
Rok vydání: 2015
Druh dokumentu: 學位論文 ; thesis
Popis: 103
Mast cell tumors (MCTs) are most common cutaneous tumors in dogs, which have various biological behaviors. Prednisolone, as a neoadjuvant, is widely used in the treatment of MCTs, and without reported postoperative complications. The aims of this study were to evaluate the relapse free interval (RFI), overall survival time (OST), and locoregional recurrence of dogs with MCTs after receiving oral prednisolone at a dose of 40 mg/m2 body surface area (BSA) once daily and assigning to follow with or without surgery. The MCTs were graded by modified 2-tier histologic grading system. Fifty-seven dogs diagnosed with MCTs were assigned to two groups: (1) NA group, 29 dogs, not followed by surgery; (2) NAS group, 28 dogs, followed by surgical removal. When evaluated not exceed three months, 25 of 29 (87.2%) dogs in NAS group had no recurrence of their tumors within 3 months; the median RFI was 39 days, ranging from 30 to 71 days. Of NAS group, dogs with low grade MCTs had longer RFI; however, there were no significant difference (P = 0.294). The median OSTs of dogs in NAS group with low grade and high grade MCTs were 225 days (ranging from 20 to 1152 days) and 181 days (ranging from 19 to 850 days), respectively, and without significant difference (P = 0.114). Night dogs of NAS group and with the maximum diameter of the mass over 5 cm or with high grade MCTs, the median OST was 355 days, ranging from 76 to 850 days, and the mean OST was 293 days. Dogs in NA group, the median OST was 48 days, ranging from 6 to 622 days. Five dogs of NA group and with the maximum diameter of the mass over 5 cm or with high grade MCTs, the median OST was 84 days, ranging from 33 to 183 days, and the mean OST was 106 days. The overall response rate of prednisolone was 61% and mean response was 75.4%. One mass had complete response [CR] (2.4%) and 24 masses had partial response [PR](58.5%). There was no significant difference comparing low grade with high grade MCTs (P=0.805). There was only one high grade MCT had CR. In addition, there were 16 low grade MCTs and 8 high grade MCTs had PR. In low grade MCTs, the mean regression percentage was 80.8%; in the other hand, it was 54.2% in high grade MCTs. The median time-span for reaching maximal tumor regression was 21 days. In conclusion, prednisolone can induce dramatic MCTs reduction even with high grade tumors. Based on the observations from this study, treatment of neoadjuvant prednisolone for 3 weeks followed by surgical removal might be recommended for patients with MCTs, especially with the maximum diameter of the mass over 5 cm or high grade MCTs.
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