背景:淋巴结清扫术在肥大细胞瘤(MCT)中的治疗作用和预后相关性历来在区域而非前哨淋巴结中进行评估。
目的:更新放射性药物引导下肿瘤切除和切除正常大小前哨淋巴结(SLN)后MCT犬的组织学结节(HN)类型与临床结果的相关性。
方法:94只经组织学证实的初治MCT犬(71只皮肤,如果没有:远处转移,则包括22个皮下和1个结膜MCT),淋巴结肿大,并发混合皮肤,和皮下MCT。
方法:这是一项单一队列研究。检索肿瘤特征,并根据Weishaar系统对SLN进行分类。MCT相关事件的发生率(本地,节点,远处复发),从头MCT或其他肿瘤和死亡(MCT相关和非MCT相关),被记录下来。比较了HN类别之间的发生率曲线。
结果:27只狗有HN0、19只HN1、37只HN2和11只HN3SLN。13人(2个HN0、4个HN2和7个HN3)接受了辅助化疗。Kiupel高级,SLN和淋巴中心数量的增加与较高的HN等级相关.五只狗因MCT相关原因死亡:1只低度(HN0)和1只皮下(HN3)局部复发,2只高级别的具有远处复发(HN3-HN0),并且1只狗从从头皮下MCT发展疾病进展。没有淋巴结复发。14只狗发展了从头MCT。
结论:低等级/低风险MCT伴无法触及且大小正常的SLN具有独立于HN的良好结局。结果应严格考虑与放射性药物标记物引导的术前和术中成功检测SLN相关。
BACKGROUND: The therapeutic role and prognostic relevance of lymphadenectomy in mast cell tumor (MCT) has historically been evaluated on regional rather than sentinel lymph nodes.
OBJECTIVE: To update information about the association of histological nodal (HN) classes with clinical outcome in dogs with MCT after tumor excision and extirpation of normal-sized sentinel nodes (SLN) guided by radiopharmaceutical.
METHODS: Ninety-four dogs with histologically-confirmed treatment-naïve MCT (71 cutaneous, 22 subcutaneous and 1 conjunctival MCT) were included if without: distant metastases, lymphadenomegaly, concurrent mixed cutaneous, and subcutaneous MCT.
METHODS: This was a monoistitutional cohort study. Tumors characteristics were retrieved and SLNs were classified according to Weishaar\'s system. Incidence of MCT-related events (local, nodal, distant relapse), de novo MCT or other tumors and death (MCT-related and non-MCT-related), were recorded. Incidence curves were compared among the HN classes.
RESULTS: Twenty-seven dogs had HN0, 19 HN1, 37 HN2, and 11 HN3 SLN. Thirteen (2 HN0, 4 HN2, and 7 HN3) received adjuvant chemotherapies. Kiupel high grade, increasing number of SLN and lymphocentrums were associated with higher HN classes. Five dogs died for MCT-related causes: 1 low-grade (HN0) and 1 subcutaneous (HN3) had a local relapse, 2 high-grade had distant relapse (HN3-HN0) and 1 dog developed disease progression from a de novo subcutaneous MCT. No nodal relapse was registered. Fourteen dogs developed de novo MCTs.
CONCLUSIONS: Low grade/low-risk MCT with nonpalpable and normal sized SLN have a favorable outcome independently from the HN. Result should be considered strictly related to the successful SLN detection guided pre- and intraoperative by radiopharmaceutical markers.