Neoadjuvant and adjuvant chemotherapy combined with anatomical resection of feline injection‐site sarcoma: results in 21 cats

Abstract

This study assesses the outcome of two combined treatment strategies for the treatment of feline injection-site sarcoma (FISS). Twenty-one cats with primary or recurrent FISS received 3 cycles of neoadjuvant chemotherapy with epirubicin (25 mg m(-2) ), then an anatomical resection of the entire muscle compartment containing the tumour was performed based on the findings of co-axial imaging. Cats then received a further 3 cycles of adjuvant chemotherapy. Follow-up was performed by telephone contact with a median follow-up time of 1072 days. Three cats (14%) developed local tumour recurrence at days 264, 664 and 1573 after surgery. A median survival time could not be calculated as over 80% of the study population remained alive or were censored due to death from other causes. When compared to historical controls, the results of this study demonstrate superior rates of tumour-free survival and disease-free interval.

Clinical and computed tomography tumour dimension assessments for planning wide excision of injection site sarcomas in cats: how strong is the agreement?

“…In small animal oncology, especially when dealing with feline ISS, the use of advanced imaging techniques in the pre-surgical setting has recently increased, but their use is still not a rule, and it is mostly left to surgeon choice. 4,7,9,15,16 In this study, tumour dimensions, both length and width, evaluated by CT showed a tendency towards being larger than the dimensions measured with calipers, consistent with previous reports. 13,16,17 In addition, in a proportion of cats, the shapes retrieved by the two methods demonstrated discrepancies.…”

“…Tumour dimension is one of the first aspects evaluated in the pre‐operative setting, to outline the prognostic consultation, as well as to calibrate the surgical dose. These considerations are particularly relevant for ISS in cats because the correct surgical approach is crucial for ensuring clean surgical margins and increasing the probability of a cure . In addition, the dimensions of ISS in cats influenced the surgical time and therefore indirectly impacted the risk of wound healing complications, which could induce postoperative morbidity and postpone other adjuvant therapies …”

Current knowledge on feline injection-site sarcoma treatment

“…Additionally, in a study performed on 12 cats with non-resectable FISS, combining doxorubicin with cyclophosphamide resulted in a partial response in 50% of cats and significant improvement in the survival time of responders [38]. Moreover, it has been demonstrated that doxorubicin used in neoadjuvant chemotherapy combined with anatomical resection of the tumour and muscle compartment prolongs both DFI and the tumour-free survival time [39]. …”

Palliative care in small animal oncology

“…Additional modifications can be made as necessary in patients in which toxicity is a problem so that quality of life is maintained during treatment. Chemotherapy can be used before (neoadjunctive) or after (adjunctive) surgery for solid tumours and occasionally as a sole agent in the palliative setting (Page and others 1993, Chun and others 1997, Bacon and others 2008, Bailey and others 2008, Bulakowski and others 2008, Grant and others 2008, Kisseberth and others 2008, Rassnick and others 2008, Cooper and others 2009, Dominguez and others 2009, Lori and others 2010, Arnold and others 2011, Fidel and others 2011, Bray and Polton 2014, Selmic and others 2014, Cannon and others 2015, Culp and others 2015, Marconato and others 2015) (Table 5). Intracavitatory chemotherapy can be useful in some patients with neoplastic pleural effusion (Charney and others 2005); permanent pleural ports are well tolerated and facilitate delivery as well as allowing drainage of the effusion.…”