Dogs undergoing surgical excision of mast cell tumors are not at increased risk of incisional complications

Abstract

OBJECTIVE To retrospectively compare the incidence of incisional complications in dogs undergoing surgery for mast cell tumors (MCTs) and soft tissue sarcomas (STSs). ANIMALS 218 dogs. PROCEDURES Dogs that underwent excision of ≥ 1 MCT, STS, or both from January 2014 to July 2019 and had ≥ 30 days postoperative follow-up were included. Signalment; anesthesia and surgery time; administration of propofol; tumor type, grade, location, and size; intended surgical margins; histologic margins; perioperative radiation, chemotherapy, and corticosteroid and antihistamine (MCT group) treatments; and incisional complications (classified as major or minor) were recorded. Follow-up information was obtained from owners or primary care veterinarians, if needed. Incidence and severity of incisional complications were compared between the MCT and STS groups. Potential risk factors were assessed for associations with incisional complications by simple and multiple logistic regression analysis. RESULTS The 218 dogs underwent surgery for 293 tumors (209 MCTs and 84 STSs). Complication rates did not differ between MCT (28/209 [13%]) and STS (12/84 [14%]) groups. For the MCT group, incomplete margins (vs complete or narrow), increasing Patnaik tumor grade, and postoperative chemotherapy (yes vs no) were associated with increased odds of incisional complications on simple regression. On multiple logistic regression, postoperative chemotherapy was associated with increased odds of incisional complications for the MCT group and both groups combined. CONCLUSIONS AND CLINICAL RELEVANCE On the basis of the results, we suggest that chemotherapy be used with caution ≤ 30 days after surgery for dogs with MCTs. Corticosteroid administration was not associated with incisional complications for the MCT group in this study.

Evaluation of Tumor Grade and Proliferation Indices before and after Short-Course Anti-Inflammatory Prednisone Therapy in Canine Cutaneous Mast Cell Tumors: A Pilot Study

“…The concerns regarding glucocorticoid treatment for cytoreduction include whether surgical margins based on post-treatment tumor size would yield complete histologic margins and whether treatment would be associated with an increased risk of post-operative incisional complications. In our study and others, surgical margins based on tumor size following pre-operative treatment with glucocorticoids have yielded complete histologic margins [22,40,99]. A long-term prospective evaluation of these patients is warranted to determine whether the local tumor recurrence rate is impacted [54].…”

“…A long-term prospective evaluation of these patients is warranted to determine whether the local tumor recurrence rate is impacted [54]. Post-operative complications following MCT resection, whether wide or intentionally marginal, are reported to be 13-29% [41,99]. Although not evaluated in our study, others have reported that dogs treated with pre-operative glucocorticoids have not had an increased risk of post-operative complications [22,40,99].…”

“…Mast cell tumors can be deemed non-resectable or not amenable to curative-intent surgical margins. In a recent study, there was a significant association with increased risk of post-operative complication in patients with MCTs and incomplete histologic margins [99]. It is reasonable to attempt cytoreduction with pre-operative glucocorticoid administration in patients with non-resectable or marginally resectable MCTs.…”

Treatment of multiple synchronous canine mast cell tumours using intratumoural tigilanol tiglate

“…The database searches retrieved more than 800 results that were narrowed down to 22 meeting eligibility criteria ( 7 – 12 , 17 , 18 , 34 , 35 , 45 – 56 ). A pooled population of 3,745 patients was analysed and, where reported, the median number of MCTs at presentation was 2 (range 2–6).…”

“…for 8 days) and a H 2 (famotidine: 0.25–0.5 mg/kg b.i.d. for 8 days) histamine receptor blocker both to be started on treatment day, were dispensed, and a suitable pre-emptive analgesia plan formulated subsequent to enrolment ( 2 , 35 ).…”