Outcome and prognostic indicators in 20 cats with surgically treated primary lung tumors

Abstract

The purpose of this retrospective study of 20 client-owned cats was to describe the clinical signs, surgical interventions, histological features, stage and treatments of primary lung tumors removed by surgical excision, and to determine which factors significantly influence survival. Any cat that underwent surgical resection of a primary lung tumor between 2000 and 2007 was included in the study. Patient records were reviewed and signalment, clinical signs, preoperative diagnostics, surgical findings and histopathological results recorded. Histological reports were reviewed and scored using World Health Organization criteria. The Kaplan-Meier test was used to evaluate each potential prognostic factor with survival. Twenty cats met the inclusion criteria. The presence of clinical signs (such as dyspnea) at the time of diagnosis (P = 0.032), pleural effusion (P = 0.046), stage M1 (P = 0.015), and moderately and poorly differentiated tumors on histopathology (P = 0.011) were factors that were significantly correlated with reduced survival times. The median survival time of the 20 cats was 11 days. Cats presenting with no clinical signs had a median survival time of 578 days post-surgery vs 4 days post-surgery when presented with clinical signs. Cats staged T1N0M0 lived longer than cats at other stages (P = 0.044). Of the cats that survived to the time of suture removal, median survival time was 64 days. The results indicate that the presence of clinical signs, pleural effusion, moderately and poorly differentiated tumors on histopathology, evidence of metastasis and any stage beyond T1N0M0 are negative prognostic indicators for cats with primary lung tumors. The findings demonstrate that cats that presented with clinical signs, pleural effusion, any stage other than T1N0M0, or moderately and poorly differentiated tumors on histopathology had a poor prognosis. Therefore, extensive preoperative diagnostics, including computed tomography scans, should be performed before considering surgical intervention in these cats. These findings may be used to guide therapeutic decision-making in cats diagnosed with primary lung tumors.

Computed Tomographic Findings in 57 Cats With Primary Pulmonary Neoplasia

“…Thoracic lymph nodes were identified inconsistently in the present study with cranial mediastinal lymph nodes identified more commonly than tracheobronchial lymph nodes. Computed tomography has been shown to have a high specificity and sensitivity for identifying tracheobronchial lymph nodes in dogs, and size and contrast enhancement of the lymph nodes has been correlated with metastatic neoplasia or granulomatous disease . Unfortunately, histopathology of lymph nodes was uncommonly performed in the cats in this study, limiting our ability to evaluate if such a correlation between size and contrast enhancement also exists in cats.…”

“…No information about cytology results of pre‐CT thoracocentesis was collected, but effusion in these cats may have been secondary to carcinomatosis, hemorrhage, lymphatic obstruction, or secondary inflammation. Pleural effusion has been reported to be a negative prognostic factor for survival after surgery . Two of the 17 cats with pleural effusion also had a pneumothorax, which may have been secondary to thoracocentesis or from mass rupture .…”

“…Treatment generally includes lung lobectomy and excision of affected lymph nodes, with or without adjunctive chemotherapy. Prognosis is dependent on differentiation of the neoplasm and whether or not metastasis has occurred …”

Spontaner Pneumothorax bei der Katze: zwei Fallberichte und Literaturübersicht

“…Unsere beiden Patienten wiesen ein primäres pulmonales Adenokarzinom auf, das Literaturangaben zufolge die am häufigsten diagnostizierte Lungenneoplasie der Katze darstellt (1,6,13). Die Literaturrecherche ergab nur drei weitere Studien, die bei insgesamt acht Katzen über eine Neoplasie als Ursache eines SP berichteten (10,11,15).…”

“…Die Prognose ist äußerst vorsichtig bis infaust. Maritato et al (13) operierten 20 Katzen mit einem primären Lungentumor. Die 16 Katzen, bei denen klinische Symptome aufgetreten waren, hatten eine mediane Überlebenszeit von nur 4 Tagen.…”