Prognostic impact of clinical, haematological, and histopathological variables in 102 canine cutaneous perivascular wall tumours

Abstract

Identification of prognostic factors for perivascular wall tumours (PWTs) is desirable to accurately predict prognosis and guide treatment. 100 and two dogs with surgically excised PWTs without distant metastasis were retrospectively enrolled in this multi‐institutional study, and the impact of pre‐treatment leukocyte parameters, clinical and histopathological variables on local recurrence (LR) and overall‐survival time (OST) were evaluated. Increasing values of white blood cell count (WBCC), neutrophil count (NC) and neutrophil‐to‐lymphocyte ratio (NLR) were significantly correlated with the hazard of LR in univariate analysis. WBCC and NC remained prognostic when adjusted for margins, grade, tumour size, location and skin ulceration, but lost their significance when adjusted for mitotic index and necrosis, whilst NLR remained prognostic only when close margins where categorised as infiltrated. Castrated males had a higher hazard of LR than intact males in univariate analysis, but significance was lost in multivariate models. Ulcerated PWTs and those located on the distal extremities had a higher hazard of LR both in univariate and multivariate analysis. Histological grade, necrosis, mitotic count, and infiltrated margins were all associated with LR both in univariate and multivariate analysis. Boxer breed, older age, ulceration, grade III, necrosis >50% and higher mitotic count were correlated with shorter OST, although breed and age lost their significance in multivariate analysis. Prognostication of surgically excised PWTs should be based on both clinical and histopathological variables. If validated in further studies, leukocyte counts and NLR may aid the clinician in identifying dogs at higher risk of LR before treatment.

Surgical Margins in Canine Cutaneous Soft-Tissue Sarcomas: A Dichotomous Classification System Does Not Accurately Predict the Risk of Local Recurrence

“…Several prognostic variables have been described alongside margin status, including histopathological and clinical features [1,5,6,20,27,39]. Hence, in the present study, the impact of margin status was adjusted for relevant prognostic variables after grouping CbCM alternatively with tumor-free or infiltrated margins, although it should be emphasized that evaluation of the impact of variables other than margin status on LR was beyond our aim, and variable selection for multivariate models was thus dictated by previous evidence of their prognostic significance [1,5,7,20,27,39].…”

“…To complicate things further, canine STS display a wide range of histological patterns and heterogenous clinical behaviors and may thus recur or not independently from completeness of excision, as suggested by the highly variable rate of LR reported for both histologically tumor-free and infiltrated margins [2,3,7,10]. Several prognostic variables have been described alongside margin status, including histopathological and clinical features [1,5,6,20,27,39]. Hence, in the present study, the impact of margin status was adjusted for relevant prognostic variables after grouping CbCM alternatively with tumor-free or infiltrated margins, although it should be emphasized that evaluation of the impact of variables other than margin status on LR was beyond our aim, and variable selection for multivariate models was thus dictated by previous evidence of their prognostic significance [1,5,7,20,27,39].…”

Safety and feasibility of short course pre‐operative radiation therapy followed by surgical excision for canine solid tumours

“…There are numerous publications that show a strong association between local tumour control and outcome 1,2 . For example, in soft tissue sarcoma (STS), the completeness of excision has a direct impact on disease‐free intervals and local recurrence risk 3–6 …”

Intraoperative assessment of canine soft tissue sarcoma by deep learning enhanced optical coherence tomography

“…Risk of local recurrence has been found to vary with histologic tumour grade and tumour location. 8 A recent systematic review found that microscopically complete margins were associated with a lower Laura E. Selmic and Mingzhai Sun are Joint senior and corresponding authors risk of local recurrence (10% recurrence rate) compared to microscopically incomplete margins (33% recurrence rate). [8][9][10][11][12] Local recurrence necessitates additional treatments, including more surgery or radiation therapy.…”

“…8 A recent systematic review found that microscopically complete margins were associated with a lower Laura E. Selmic and Mingzhai Sun are Joint senior and corresponding authors risk of local recurrence (10% recurrence rate) compared to microscopically incomplete margins (33% recurrence rate). [8][9][10][11][12] Local recurrence necessitates additional treatments, including more surgery or radiation therapy. Various imaging tools have been used for intraoperative assessment of tumour and surgical margins, identifying any residual microscopic disease and real-time guidance of surgical decisions.…”