Canine Osteosarcoma Treated by Post-Amputation Sequential Accelerated Doxorubicin and Carboplatin Chemotherapy: 38 Cases

Abstract

Canine appendicular osteosarcoma is an important clinical problem in veterinary medicine. Current standard therapy includes amputation followed by chemotherapy, which improves outcomes; however the percentage of long-term survival is still relatively low at 15-20%. Established prognostic factors include serum alkaline phosphatase level, histologic grade, and lymphocyte and monocyte counts. We used a protocol with shorter inter-treatment intervals than standard, but which we expected to still be well-tolerated, based on drugs known to be active agents, with the aim of improving outcomes by increasing dose intensity. Thirty-eight dogs with confirmed appendicular osteosarcoma and no pulmonary metastases that underwent amputation followed by this chemotherapy protocol were retrospectively evaluated. The median survival time was 317 days and 1- and 2-yr survival percentages were 43.2% and 13.9%, respectively. Toxicity was comparable to that seen with other standard dose protocols, with 5.2% of dogs hospitalized for complications that resolved with supportive care and no chemotherapy-related mortality. Serum alkaline phosphatase level (normal or high) (p = 0.004) and whether or not chemotherapy was completed (p = 0.001) were found to significantly impact survival time on multivariate analysis. Outcomes were similar to those reported with most other published chemotherapy protocols for dogs with this disease.

Effect of surgical site infection on survival after limb amputation in the curative‐intent treatment of canine appendicular osteosarcoma: a Veterinary Society of Surgical Oncology retrospective study

“…[3][4][5][6][7][8] The median survival time (MST) reported with curativeintent treatment ranges between 258 days and 18 months. [3][4][5][6][7][8][9][10][11] Clinical factors associated with individual dog survival include tumor location, elevated serum alkaline phosphatase (ALP), increasing body weight, and evidence of metastasis at the time of diagnosis. [12][13][14][15] Limb-sparing surgery provides an alternative option for local tumor control.…”

Comparative Assessment of the Accuracy of Cytological and Histologic Biopsies in the Diagnosis of Canine Bone Lesions

“…Representative examples of cytological specimens are provided in Figure 4. The mean number of slides per case was 5 (range, [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16][17]. Cellularity was poor in 16 cases (30.2%) and moderate to high in the remaining 37 cases (69.8%).…”

“…The median survival time for dogs with appendicular OSA treated with limb amputation and chemotherapy ranges from 8 to 18 months. [4][5][6][7] Primary HSA of bone is an equally aggressive tumor, with median survival times <1 year. 1 Conversely, CSA and FSA share a lower metastatic potential and surgery alone might be curative.…”

Immune dysregulation and osteosarcoma: Staphylococcus aureus downregulates TGF‐β and heightens the inflammatory signature in human and canine macrophages suppressed by osteosarcoma

“…Of the many similarities between human and canine OS such as biological behaviour, histological characteristics and gene expression signatures, perhaps the most dismal similarity is the lack of significant improvement in survival over the past three decades. Despite attempts with various permutations of chemotherapeutics, the median survival in dogs with OS remains between 10 and 12 months, and the 5‐year disease‐free interval for human patients with non‐metastatic OS remains around 70%, with only 20% to 30% long‐term survival expected in patients that present with metastases . To improve the clinical outcomes for this disease, investigations into novel avenues of treating OS are sorely needed.…”

“…Despite attempts with various permutations of chemotherapeutics, the median survival in dogs with OS remains between 10 and 12 months, and the 5-year disease-free interval for human patients with nonmetastatic OS remains around 70%, with only 20% to 30% long-term survival expected in patients that present with metastases. 2,[4][5][6] To improve the clinical outcomes for this disease, investigations into novel avenues of treating OS are sorely needed.…”