Survival analysis in dogs with urinary transitional cell carcinoma that underwent whole‐body computed tomography at diagnosis

Abstract

This retrospective study aimed to evaluate factors associated with survival and to compare characteristics between tumour localizations in dogs with urinary transitional cell carcinoma (TCC) that underwent whole‐body computed tomography (CT) at diagnosis. Dogs with histologically confirmed TCC that received medical therapy between 2010 and 2017 were included; dogs that underwent surgery or radiotherapy for the primary tumour were excluded. According to the CT findings, primary tumour localization (classified into the Bladder, Urethra and Bladder and Urethra groups), prostate involvement, iliosacral lymphadenomegaly, sternal lymphadenomegaly and metastasis to the bone and lung were evaluated for survival analysis. CT at diagnosis revealed iliosacral lymphadenomegaly, sternal lymphadenomegaly, bone metastasis and lung metastasis in 47.7%, 18.5%, 24.6% and 35.4% of the 65 included dogs, respectively. The overall median survival time was 196 days. On multivariable analysis, TCC localization (hazard ratio [HR], 1.90; P = .037), bone metastasis (HR, 2.76; P = .013) and sternal lymphadenomegaly (HR, 3.56; P = .004) were significantly associated with survival. Compared to the Bladder group (n = 16), the Urethra group (n = 26) had higher metastasis rates to the bone (6.3% vs 42.3%; P = .045) and lung (6.3% vs 46.2%; P = .022). The survival time was shorter in the Urethra group than in the Bladder group (121.5 vs 420 days; P < .001), and it was similar only in female dogs (247 vs 420 days; P = .031). These findings suggest that whole‐body CT could be valuable for predicting the prognosis in urinary TCC.

Urothelial cell carcinoma with widespread local and distant metastasis and associated osseous metaplasia in a dog

“…In one large post‐mortem study ( n = 137 cases), 58% of dogs with urothelial cell carcinoma had documented distant metastases 3,6 . Known predilection sites for metastases include MILNs, lungs, liver, skin and vertebral bodies 5,7–9 . Hypertrophic osteopathy has also been seen concurrent to urothelial carcinoma 5 .…”

“…3,6 Known predilection sites for metastases include MILNs, lungs, liver, skin and vertebral bodies. 5,[7][8][9] Hypertrophic osteopathy has also been seen concurrent to urothelial carcinoma. 5 Stromal osseous metaplasia occurs when part of the tumoral stroma of urothelial carcinomas transforms into mature bone, characterised by bone trabeculae forming a lamellar architecture.…”

What Is Your Diagnosis?

“…It is especially important to differentiate smooth muscle tumors from urothelial carcinomas (UCs), more commonly known as TCCs, which are the most common urinary bladder tumor in dogs and are often nonsurgical. 1,3,4 TCCs tend to track through the urinary bladder trigone, proximal urethra, and prostate, and they are highly metastatic to the prostate and regional lymph nodes, bones, and lungs. 3,4 Incomplete surgical excision often leads to fast and aggressive recurrence.…”

“…1,3,4 TCCs tend to track through the urinary bladder trigone, proximal urethra, and prostate, and they are highly metastatic to the prostate and regional lymph nodes, bones, and lungs. 3,4 Incomplete surgical excision often leads to fast and aggressive recurrence.…”

A combined protocol with piroxicam, chemotherapy, and whole pelvic irradiation with simultaneous boost volumetric modulated arc radiotherapy for muscle-invasive canine urinary transitional cell carcinoma: First clinical experience

“…Dogs with invasive TCC have different treatment options, including cyclooxygenase (COX) inhibitors (e.g., piroxicam, deracoxib, and pirocoxib) [ 26 , 32 , 34 , 35 , 36 , 38 , 39 , 57 , 63 ], cytotoxic chemotherapy drugs (cisplatin, carboplatin, mitoxantrone, vinblastine, gemcitabine) [ 1 , 19 , 26 , 28 , 34 , 35 , 36 , 39 , 54 ], metronomic chemotherapy (chlorambucil) [ 13 , 20 , 23 , 24 , 47 , 48 , 49 , 64 , 68 , 69 ], laser ablation [ 14 , 26 , 43 ], urethral or ureteral stent placement [ 9 , 26 , 52 , 74 ], surgery [ 11 , 26 , 29 , 34 , 35 , 50 , 54 , 66 , 67 , 70 , 76 , 77 ], and other radiation therapy protocols [ 55 , 56 , 62 , 73 ]; however, a single treatment that leads to a robust response is lacking.…”