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Sabattini S, Brocanelli A, Zaccone R, Faroni E, Renzi A, Ciammaichella L, Bettini G, Marconato L. The 2-tier grading system identifies canine cutaneous and/or subcutaneous mast cell tumors with aggressive biological behavior regardless of growth model. Vet Pathol 2024:3009858241240443. [PMID: 38577816 DOI: 10.1177/03009858241240443] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2024]
Abstract
Histologic grading of canine cutaneous mast cell tumors (cMCTs) has prognostic and therapeutic implications, yet validation for subcutaneous MCTs (scMCTs) is lacking. For scMCTs with or without dermal invasion, determining their biological behavior remains poorly standardized and sometimes sparks controversy. This prospective study aimed to assess the prognostic utility of the 2-tier histologic grading system in MCTs with different growth models (GMs) and explore the prognostic impact of the GM itself. We assessed 6 histologic GM categories: solely cMCT (C-SC0), cMCT with superficial (C-SC1) or deep subcutaneous (C-SC2) involvement, solely scMCT (SC-C0), and scMCT with deep (SC-C1) or superficial (SC-C2) infiltration of the dermis. Ninety-one MCTs from 76 dogs undergoing excision and regional/sentinel lymphadenectomy were examined. GM classification identified 11 (12%) C-SC0 tumors, 12 (13%) C-SC1, 15 (16%) C-SC2, 21 (23%) SC-C0, 15 (16%) SC-C1, and 17 (19%) SC-C2. Mitotic count, 2-tier grade, nodal involvement, surgical margins, and outcome were stratified according to GM. scMCTs lacking dermal invasion, historically associated with a benign clinical course, had a poor prognosis in 10% of cases. cMCTs exhibiting deep subcutaneous involvement included the largest percentage of high-grade tumors (33%), had the highest occurrence of overt nodal metastases (33%), and had the lowest 1-year survival rate (86%). Histologic grade was confirmed as a relevant prognostic factor, surpassing nodal involvement and histologic margin status. The 2-tier histologic grading enabled the identification of all MCTs with aggressive biological behavior, regardless of their cutaneous or subcutaneous location.
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Ferrari R, Marconato L, Boracchi P, Stefanello D, Godizzi F, Murgia D, Schievenin V, Amati M, Faroni E, Roccabianca P. Splenic stromal sarcomas in dogs: Outcome and clinicopathological prognostic factors in 32 cases. Vet Comp Oncol 2024; 22:12-21. [PMID: 37918913 DOI: 10.1111/vco.12941] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 10/06/2023] [Accepted: 10/19/2023] [Indexed: 11/04/2023]
Abstract
Due to the low frequency and the changes in diagnostic techniques and terminology during the last few years, only little clinical information is available on splenic stromal sarcoma (SSS). This multi-institutional study aimed at gathering clinical cases of SSS in dogs and investigates their clinical behaviour, as well as analyse possible clinicopathological prognostic factors, including the use of adjuvant therapy. Dogs with a histologically confirmed SSS that underwent splenectomy were retrospectively included. To be included in the study, either FFPE tissue blocks or multiple tissue sections had to be available for histopathologic and immunohistochemical revision. Clinical and pathological variables, along with adjuvant therapy data, were collected. Cumulative incidence of metastatic disease was analysed through univariate and bivariate analyses. The impact of adjuvant chemotherapy on metastasis incidence and survival was assessed, considering an estimated propensity score. A total of 32 dogs were included. Among them, 22 developed metastases with an incidence of 37.5%, 59.38%, and 65.94% at 6, 12, and 24 months, respectively. Univariate analysis identified mitotic count, total scoring, and necrosis as prognostic factors. In bivariate analysis, mitotic count remained prognostic. The administration of adjuvant chemotherapy did not have an impact on metastasis incidence or survival time. The study found that dogs with SSSs are at high risk of metastasis, although a small subgroup may experience longer survival after splenectomy. Mitotic count was the only variable having a reliable prognostic impact. Adjuvant chemotherapy did not appear to decrease the incidence of metastasis or prolong survival in these dogs.
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Affiliation(s)
- Roberta Ferrari
- Dipartimento di Medicina Veterinaria e Scienze Animali, Università degli Studi di Milano, Lodi, Italy
| | - Laura Marconato
- Dipartimento di Scienze Mediche Veterinarie, Alma Mater Studiorum, Università di Bologna, Ozzano dell'Emilia, Italy
| | - Patrizia Boracchi
- Dipartimento di Scienze Cliniche e di Comunità, Laboratorio di Statistica Medica, Biometria ed Epidemiologia "G.A. Maccacaro", Università degli Studi di Milano, Milan, Italy
| | - Damiano Stefanello
- Dipartimento di Medicina Veterinaria e Scienze Animali, Università degli Studi di Milano, Lodi, Italy
| | - Francesco Godizzi
- Dipartimento di Medicina Veterinaria e Scienze Animali, Università degli Studi di Milano, Lodi, Italy
| | | | | | - Maria Amati
- Dipartimento di Medicina Veterinaria e Scienze Animali, Università degli Studi di Milano, Lodi, Italy
| | - Eugenio Faroni
- Dipartimento di Scienze Mediche Veterinarie, Alma Mater Studiorum, Università di Bologna, Ozzano dell'Emilia, Italy
| | - Paola Roccabianca
- Dipartimento di Medicina Veterinaria e Scienze Animali, Università degli Studi di Milano, Lodi, Italy
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Corsini A, Lunetta F, Alboni F, Drudi I, Faroni E, Fracassi F. Development and internal validation of diagnostic prediction models using machine-learning algorithms in dogs with hypothyroidism. Front Vet Sci 2023; 10:1292988. [PMID: 38169885 PMCID: PMC10758480 DOI: 10.3389/fvets.2023.1292988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2023] [Accepted: 12/08/2023] [Indexed: 01/05/2024] Open
Abstract
Introduction Hypothyroidism can be easily misdiagnosed in dogs, and prediction models can support clinical decision-making, avoiding unnecessary testing and treatment. The aim of this study is to develop and internally validate diagnostic prediction models for hypothyroidism in dogs by applying machine-learning algorithms. Methods A single-institutional cross-sectional study was designed searching the electronic database of a Veterinary Teaching Hospital for dogs tested for hypothyroidism. Hypothyroidism was diagnosed based on suggestive clinical signs and thyroid function tests. Dogs were excluded if medical records were incomplete or a definitive diagnosis was lacking. Predictors identified after data processing were dermatological signs, alopecia, lethargy, hematocrit, serum concentrations of cholesterol, creatinine, total thyroxine (tT4), and thyrotropin (cTSH). Four models were created by combining clinical signs and clinicopathological variables expressed as quantitative (models 1 and 2) and qualitative variables (models 3 and 4). Models 2 and 4 included tT4 and cTSH, models 1 and 3 did not. Six different algorithms were applied to each model. Internal validation was performed using a 10-fold cross-validation. Apparent performance was evaluated by calculating the area under the receiver operating characteristic curve (AUROC). Results Eighty-two hypothyroid and 233 euthyroid client-owned dogs were included. The best performing algorithms were naive Bayes in model 1 (AUROC = 0.85; 95% confidence interval [CI] = 0.83-0.86) and in model 2 (AUROC = 0.98; 95% CI = 0.97-0.99), logistic regression in model 3 (AUROC = 0.88; 95% CI = 0.86-0.89), and random forest in model 4 (AUROC = 0.99; 95% CI = 0.98-0.99). Positive predictive value was 0.76, 0.84, 0.93, and 0.97 in model 1, 2, 3, and 4, respectively. Negative predictive value was 0.89, 0.89, 0.99, and 0.99 in model 1, 2, 3, and 4, respectively. Discussion Machine learning-based prediction models were accurate in predicting and quantifying the likelihood of hypothyroidism in dogs based on internal validation performed in a single-institution, but external validation is required to support the clinical applicability of these models.
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Affiliation(s)
- Andrea Corsini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy
- Department of Veterinary Sciences, University of Parma, Parma, Italy
| | - Francesco Lunetta
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy
| | - Fabrizio Alboni
- Department of Statistical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Ignazio Drudi
- Department of Statistical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Eugenio Faroni
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy
| | - Federico Fracassi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Ozzano Emilia, Italy
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Marconato L, Stefanello D, Solari Basano F, Faroni E, Dacasto M, Giantin M, Bettini G, Aresu L, Bonfanti U, Bertazzolo W, Annoni M, Lecchi C, Sabattini S. Subcutaneous mast cell tumours: A prospective multi-institutional clinicopathological and prognostic study of 43 dogs. Vet Rec 2023:e2991. [PMID: 37224084 DOI: 10.1002/vetr.2991] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Revised: 02/27/2023] [Accepted: 04/06/2023] [Indexed: 05/26/2023]
Abstract
BACKGROUND Canine subcutaneous mast cell tumours (ScMCTs) reportedly have a good prognosis. However, biomarkers that can be used to predict outcome are currently limited. METHODS A multicentre prospective study was conducted to identify new prognostic markers. Dogs with a first occurrence of ScMCT were enrolled upon primary tumour removal and regional lymphadenectomy. In the absence of metastasis, dogs were monitored, while dogs with overtly metastatic lymph nodes (histological node 3, HN3) received adjuvant vinblastine. RESULTS Forty-three dogs were enrolled: 15 (34.9%) had at least one HN3 lymph node and received vinblastine, and 28 (65.1%) were monitored. Three tumours harboured exon 8 and 9 c-kit mutations. Eight (18.6%) dogs experienced tumour progression, and five (11.6%) died of MCT-related causes. The 1- and 2-year survival rates were 90% and 77%, respectively. Variables significantly associated with an increased risk of progression included high cytograde, a mitotic count (MC) greater than 4/10 high-power fields (hpf) and Ki67-index greater than 23. An MC greater than 4/10 hpf was also associated with an increased risk of tumour-related death. LIMITATIONS Regional rather than sentinel lymphadenectomy was performed in these dogs. Dogs were enrolled in oncology referral centres, constituting a different population compared to previous studies. CONCLUSIONS ScMCTs have a good prognosis. However, the metastatic rate at admission was higher in this study than previously reported, and a subset of tumours were associated with a fatal outcome despite multimodal treatment. Proliferative activity and cytograding may predict more aggressive behaviour in ScMCTs.
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Affiliation(s)
- Laura Marconato
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Damiano Stefanello
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy
| | | | - Eugenio Faroni
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Mauro Dacasto
- Department of Comparative Biomedicine and Food Science, University of Padua, Legnaro, Italy
| | - Mery Giantin
- Department of Comparative Biomedicine and Food Science, University of Padua, Legnaro, Italy
| | - Giuliano Bettini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Luca Aresu
- Department of Veterinary Sciences, University of Turin, Grugliasco, Italy
| | | | | | | | - Cristina Lecchi
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
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Faroni E, Sabattini S, Guerra D, Iannuzzi C, Chalfon C, Agnoli C, Stefanello D, Polton G, Ramos S, Aralla M, Ciaccini R, Foglia A, Okonji S, Marconato L. Timely adjuvant chemotherapy improves outcome in dogs with non-metastatic splenic hemangiosarcoma undergoing splenectomy. Vet Comp Oncol 2023; 21:123-130. [PMID: 36633399 DOI: 10.1111/vco.12875] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2022] [Revised: 12/24/2022] [Accepted: 12/30/2022] [Indexed: 01/13/2023]
Abstract
Timely delivery of adjuvant chemotherapy has been shown to be advantageous in many human cancers and canine osteosarcoma. Adjuvant chemotherapy has been shown to improve outcome for canine splenic hemangiosarcoma. The aim of this retrospective study was to investigate whether timely adjuvant chemotherapy administration resulted in better outcome in dogs with non-metastatic splenic hemangiosarcoma undergoing splenectomy. Medical records were searched for dogs with non-metastatic, splenic hemangiosarcoma that received splenectomy and adjuvant chemotherapy. The number of days from surgery to the first chemotherapy dose (StoC) was evaluated to identify the cut-off value associated with the best survival advantage. StoC and other possible prognostic factors were tested for influence on time to metastasis (TTM) and overall survival (OS). Seventy dogs were included. Median StoC was 20 days (range: 4-70). The time interval associated with the greatest survival benefit was 21 days. Median TTM and OS of dogs with StoC ≤ 21 days were significantly longer than those with StoC >21 days (TTM: 163 vs. 118 days, p = .001; OS: 238 vs. 146 days, p < .001). On multivariable analysis, StoC >21 days was the only variable significantly associated with increased risk of tumour progression (HR 2.1, p = .010) and death (HR 2.3; p = .008). Starting adjuvant chemotherapy within 21 days of surgery may be associated with a survival benefit in dogs with non-metastatic splenic hemangiosarcoma, possibly due to the early targeting of newly recruited metastatic cells after surgery.
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Affiliation(s)
- Eugenio Faroni
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Dina Guerra
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Chiara Iannuzzi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Carmit Chalfon
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Chiara Agnoli
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Damiano Stefanello
- Department of Veterinary Medicine and Animal Sciences, University of Milan, Lodi, Italy
| | - Gerry Polton
- North Downs Specialist Referrals, Bletchingley, UK
| | - Sofia Ramos
- North Downs Specialist Referrals, Bletchingley, UK
| | | | | | - Armando Foglia
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Samuel Okonji
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
| | - Laura Marconato
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Ozzano dell'Emilia, Italy
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Sabattini S, Faroni E, Zaccone R, Marconato L, Bettini G. Do "mastophages" hamper the histologic assessment of lymph node metastases in canine mast cell tumor? J Vet Diagn Invest 2022; 34:927-928. [PMID: 36178250 PMCID: PMC9597344 DOI: 10.1177/10406387221127457] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Affiliation(s)
- Silvia Sabattini
- Silvia Sabattini, Department of
Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Via Tolara di
Sopra 50, Ozzano dell’Emilia (BO) 40126, Italy.
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Chalfon C, Sabattini S, Finotello R, Faroni E, Guerra D, Pisoni L, Ciammaichella L, Vasconi ME, Annoni M, Marconato L. Lymphadenectomy improves outcome in dogs with resected Kiupel high-grade cutaneous mast cell tumours and overtly metastatic regional lymph nodes. J Small Anim Pract 2022; 63:661-669. [PMID: 35733233 DOI: 10.1111/jsap.13525] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/31/2022] [Revised: 04/12/2022] [Accepted: 05/09/2022] [Indexed: 01/18/2023]
Abstract
INTRODUCTION Historically, the prognosis for dogs with stage II Kiupel high-grade cutaneous mast cell tumours has been considered poor. OBJECTIVES The aim of this study was to explore the impact of lymphadenectomy on outcome in dogs with Kiupel high-grade cutaneous mast cell tumours and overt regional lymph node metastasis. MATERIAL AND METHODS Data from dogs with completely staged Kiupel high-grade cutaneous mast cell tumours with overt and/or certain regional lymph node metastasis undergoing excision of the primary tumours and adjuvant medical treatment were extracted. Dogs with a cytological diagnosis of regional lymph node metastasis that did not undergo lymphadenectomy were compared with dogs that underwent lymphadenectomy and had a histological diagnosis of overt lymph node metastasis. RESULTS Forty-nine dogs were included, 18 did not undergo lymphadenectomy while 31 underwent lymphadenectomy. Median time to progression was significantly shorter in dogs that did not undergo lymphadenectomy (150 days, 95% confidence interval: 129 to 170) compared to the other dogs (229 days, 95% confidence interval: 191 to 266). Median survival time was also shorter in dogs that did not undergo lymphadenectomy (250 days, 95% confidence interval: 191 to 308) compared to dogs that underwent lymphadenectomy (371 days, 95% confidence interval: 311 to 430). On multivariable analysis, lack of lymphadenectomy was associated with higher risk of overall tumour progression (hazard ratio: 2.05, 95% confidence interval: 1.02 to 4.13), nodal progression (hazard ratio: 3.4, 95% confidence interval: 1.65 to 7.02) and tumour-related death (hazard ratio 3.63, 95% confidence interval: 1.72 to 7.66), whereas tumour size was associated with higher risk of local recurrence (hazard ratio: 3.61, 95% confidence interval: 1.06 to 13). CLINICAL SIGNIFICANCE Regional lymphadenectomy may improve outcome in dogs with biologically aggressive cutaneous mast cell tumours.
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Affiliation(s)
- C Chalfon
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - S Sabattini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - R Finotello
- Depertment of Small Animal Clinical Sciences, Institute of Veterinary Science, University of Liverpool, Neston, CH64 7TE, UK
| | - E Faroni
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - D Guerra
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - L Pisoni
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - L Ciammaichella
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
| | - M E Vasconi
- Centro Veterinario Torinese, Turin, 10153, Italy
| | - M Annoni
- Clinica Veterinaria Tibaldi, Milan, 20141, Italy
| | - L Marconato
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, 40126, Italy
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Zaccone R, Renzi A, Chalfon C, Lenzi J, Bellei E, Marconato L, Ros E, Rigillo A, Bettini G, Faroni E, Guerra D, Sabattini S. Environmental risk factors for the development of oral squamous cell carcinoma in cats. J Vet Intern Med 2022; 36:1398-1408. [PMID: 35633064 PMCID: PMC9308430 DOI: 10.1111/jvim.16372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Revised: 01/17/2022] [Accepted: 01/19/2022] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Risk factors for oral squamous cell carcinoma (OSCC) in cats are derived from a single study dated almost 20 years ago. The relationship between inflammation of oral tissues and OSCC is still unclear. OBJECTIVES To investigate previously proposed and novel potential risk factors for OSCC development, including oral inflammatory diseases. ANIMALS Hundred cats with OSCC, 70 cats with chronic gingivostomatitis (CGS), 63 cats with periodontal disease (PD), and 500 controls. METHODS Prospective, observational case-control study. Cats with OSCC were compared with an age-matched control sample of client-owned cats and cats with CGS or PD. Owners of cats completed an anonymous questionnaire including demographic, environmental and lifestyle information. RESULTS On multivariable logistic regression, covariates significantly associated with an increased risk of OSCC were rural environment (OR: 1.77; 95% CI: 1.03-3.04; P = .04), outdoor access (OR: 1.68; 95% CI: 1.07-2.63; P = .02), environmental tobacco smoke (OR: 1.77; 95% CI: 1.05-3; P = .03), and petfood containing chemical additives (OR: 1.98; 95% CI: 1.04-3.76; P = .04). Risk factors shared with CGS and PD were outdoor access and petfood containing chemical additives, respectively. A history of oral inflammation was reported in 35% of cats with OSCC but did not emerge as a risk factor. CONCLUSIONS AND CLINICAL IMPORTANCE The study proposes novel potential risk factors for OSCC in cats. Although a history of inflammatory oral disease was not significantly more frequent compared with random age-matched controls, OSCC shared several risk factors with CGS and PD.
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Affiliation(s)
- Riccardo Zaccone
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Andrea Renzi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Carmit Chalfon
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Emma Bellei
- I Portoni Rossi Veterinary Hospital, Bologna, Italy
| | - Laura Marconato
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | | | - Antonella Rigillo
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Giuliano Bettini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Eugenio Faroni
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Dina Guerra
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum-University of Bologna, Bologna, Italy
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Sabattini S, Faroni E, Renzi A, Ghisoni G, Rigillo A, Bettini G, Pasquini A, Zanardi S, Guerra D, Marconato L. Longitudinal lymph node step-sectioning for the identification of metastatic disease in canine mast cell tumor. Vet Pathol 2022; 59:768-772. [DOI: 10.1177/03009858221088780] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Lymph node (LN) metastasis in canine mast cell tumor (MCT) can affect prognosis and postsurgical treatment recommendations; however, routine histological single-section examination may underestimate the incidence of metastases. This prospective study aimed at determining whether longitudinal step-sectioning of the entire LN allows for a more reliable detection of metastases. Dogs with MCT undergoing resection of the primary tumor and regional lymphadenectomy were enrolled. Formalin-fixed LNs were bisected longitudinally, both halves were embedded in paraffin and histological sections prepared at 200 μm steps. The nodal mast cells were classified according to the Weishaar classification. First-section evaluation (FSE; ie, examination of the first section obtained from the blocks) and whole LN step-section evaluation (SSE) were compared. Fifty-eight LNs were included. The median number of sections per LN was 6 (range, 3–28). FSE with toluidine blue (TB) revealed 27 (47%) nonmetastatic (HN0), 14 (24%) premetastatic (HN1), 9 (15%) early metastatic (HN2), and 8 (14%) overtly metastatic (HN3) LNs. SSE with TB resulted in upgrading the LN status in 2 cases (HN2 to HN3; HN0 to HN1). Evaluation of the first section plus an additional step-section resulted in 100% accuracy. Compared with SSE with TB, the accuracy of FSE with HE was 98% for HN3 LNs and 74% for HN2 LNs. FSE appears to reliably allow for the detection of LN metastasis in MCT, although examination of a further parallel section at a 200 μm step may increase the accuracy. A metachromatic stain is recommended for the identification of early metastases.
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Affiliation(s)
- Silvia Sabattini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Eugenio Faroni
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Andrea Renzi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Giulia Ghisoni
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Antonella Rigillo
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Giuliano Bettini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Arianna Pasquini
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Stefano Zanardi
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Dina Guerra
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
| | - Laura Marconato
- Department of Veterinary Medical Sciences, University of Bologna, Bologna, Italy
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Guerra D, Faroni E, Sabattini S, Agnoli C, Chalfon C, Stefanello D, Del Magno S, Cola V, Grieco V, Marconato L. Histologic grade has a higher-weighted value than nodal status as predictor of outcome in dogs with cutaneous mast cell tumors and overtly metastatic sentinel lymph nodes. Vet Comp Oncol 2022; 20:551-558. [PMID: 35195937 DOI: 10.1111/vco.12806] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/03/2021] [Revised: 02/16/2022] [Accepted: 02/17/2022] [Indexed: 11/29/2022]
Abstract
In canine cutaneous mast cell tumors (cMCTs), histologic grade and clinical stage are the most important prognostic factors, with high-grade tumors and metastatic lymph nodes (LNs) significantly influencing the evolution of disease. However, it is uncertain whether histologic grade and clinical stage should be given equal weighting value in patient prognostication and management. Dogs with low- and high-grade cMCTs and at least one overtly metastatic sentinel LN undergoing standardized treatment, consisting of surgical excision of the cMCT, lymphadenectomy and chemotherapy, were retrospectively included. The aim was to determine whether, at the same clinical stage, histologic grade retained prognostic relevance. Sixty dogs were included: 26 had a high-grade cMCT tumor and 34 had a low-grade cMCT. Median follow-up was 367 days (range, 187-748) in the high-grade group, and 1208 days (range, 180-2576) in the low-grade group. Median time to progression was significantly shorter in the high-grade group than in the low-grade group (214 days versus not reached; P<0.001), as well as tumor-specific survival (545 days versus not reached; P<0.001). On multivariable analysis, a high histologic grade and incomplete margins retained prognostic significance for both tumor progression and tumor-specific death. In dogs with cMCT and at least one overtly metastatic LN undergoing multimodal treatment, histologic grade significantly correlated with outcome. Overall prognosis was not unfavorable, even in the high-grade group, further supporting that a multimodal therapeutic approach, addressing primary tumor and sentinel LN, should be offered. Whether chemotherapy should be incorporated in the therapeutic planning of low-grade cMCTs remains to be defined. This article is protected by copyright. All rights reserved.
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Affiliation(s)
- Dina Guerra
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia (Bologna), Italy
| | - Eugenio Faroni
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia (Bologna), Italy
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia (Bologna), Italy
| | - Chiara Agnoli
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia (Bologna), Italy
| | - Carmit Chalfon
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia (Bologna), Italy
| | - Damiano Stefanello
- Dipartimento di Medicina Veterinaria Università degli Studi di Milano, Lodi, Italy
| | - Sara Del Magno
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia (Bologna), Italy
| | - Veronica Cola
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia (Bologna), Italy
| | - Valeria Grieco
- Dipartimento di Medicina Veterinaria Università degli Studi di Milano, Lodi, Italy
| | - Laura Marconato
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia (Bologna), Italy
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Renzi A, Faroni E, Ghisoni G, Bettini G, Marconato L, Pasquini A, Zanardi S, Sabattini S. Diagnostic Impact of Longitudinal Lymph Node Step-Sectioning for the Identification of Metastatic Disease in Canine Mast Cell Tumour. J Comp Pathol 2022. [DOI: 10.1016/j.jcpa.2021.11.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Faroni E, Sabattini S, Lenzi J, Guerra D, Comazzi S, Aresu L, Mazzanti A, Zanardi S, Cola V, Lotito E, Marconato L. Sleeping Beauty: Anesthesia May Promote Relapse in Dogs With Diffuse Large B-Cell Lymphoma in Complete Remission After Chemo-Immunotherapy. Front Vet Sci 2021; 8:760603. [PMID: 34881319 PMCID: PMC8645585 DOI: 10.3389/fvets.2021.760603] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Accepted: 10/28/2021] [Indexed: 11/20/2022] Open
Abstract
Surgery-induced stress and anesthesia-related immunosuppression are believed to play a critical role in human oncology patients. Studies have hypothesized that anesthesia influences patients' outcome, promoting tumor recurrence and metastasis. Aim of the study was to investigate whether anesthesia promoted relapse in dogs with diffuse large B-cell lymphoma (DLBCL). Medical records were searched for dogs with DLBCL, that were in complete remission (CR) after the same chemo-immunotherapy protocol. Dogs receiving anesthesia were included if the procedure was performed while in CR. Time to relapse (TTR) was obtained via Kaplan–Meier method. Association between anesthesia and relapse was assessed using a nested case-control design and estimated using conditional logistic regression. Sixty-one dogs with DLBCL were included. Overall median TTR was 329 days (95% CI, 281–377). Forty-eight (79%) dogs relapsed during the study period, while 13 (21%) were still in CR at data analysis closure. Eighteen (30%) dogs received anesthesia with opioids, propofol, and isoflurane or sevoflurane. The relative risk of lymphoma relapse for dogs undergoing anesthesia was significantly higher compared with dogs not undergoing anesthesia, with an odds ratio of 3.09 (P = 0.019) on multivariable analysis. Anesthesia may promote relapse in dogs with DLBCL treated with chemo-immunotherapy, although a role of perioperative stress cannot be ultimately excluded. Considering the high frequency of anesthetic procedures required for diagnostic and therapeutic protocols among oncology patients, it is of utmost interest to characterize the effects of single anesthetic agents on the immune system. Further prospective studies are needed to better define the impact of anesthesia on patients' outcome.
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Affiliation(s)
- Eugenio Faroni
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Silvia Sabattini
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Jacopo Lenzi
- Department of Biomedical and Neuromotor Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Dina Guerra
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Stefano Comazzi
- Department of Veterinary Medicine, University of Milano, Lodi, Italy
| | - Luca Aresu
- Department of Veterinary Sciences, University of Torino, Turin, Italy
| | - Alessia Mazzanti
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Stefano Zanardi
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Veronica Cola
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
| | - Emilio Lotito
- Clinica Veterinaria Dell'Orologio, Sasso Marconi, Bologna, Italy
| | - Laura Marconato
- Department of Veterinary Medical Sciences, Alma Mater Studiorum University of Bologna, Bologna, Italy
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Sabattini S, Kiupel M, Finotello R, Stefanello D, Faroni E, Bertazzolo W, Bonfanti U, Rigillo A, Del Magno S, Foglia A, Aresu L, Gambini M, Caniatti M, Marconato L. A retrospective study on prophylactic regional lymphadenectomy versus nodal observation only in the management of dogs with stage I, completely resected, low-grade cutaneous mast cell tumors. BMC Vet Res 2021; 17:331. [PMID: 34649575 PMCID: PMC8518262 DOI: 10.1186/s12917-021-03043-0] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 09/30/2021] [Indexed: 02/02/2023] Open
Abstract
BACKGROUND While lymphadenectomy of metastatic lymph nodes (LNs) has been associated with improved outcome, the clinical utility of prophylactic lymphadenectomy in dogs with stage I cutaneous mast cell tumors (cMCTs) remains a controversial topic. To assess the therapeutic role of lymphadenectomy of uninvolved regional LNs, the long-term outcome of cMCT-bearing dogs with cytologically negative and surgically unresected regional LNs (observation only, OO) was compared with that of dogs with surgically resected and histologically negative regional LNs (prophylactic regional lymphadenectomy, PRL). RESULTS A retrospective analysis of 64 dogs with a low-grade, completely resected stage I cMCT was performed: 35 (54.7%) dogs were subjected to OO and 29 (45.3%) underwent PRL. Dogs were monitored for a median of 813 and 763 days in the OO group and PRL group, respectively. The number of dogs undergoing MCT progression was significantly higher in the OO group (P = 0.028) and curve comparison revealed a tendency to a better time to progression in the PRL group (P = 0.058). No significant difference in survival time (P = 0.294) was observed between dogs in the OO and PRL groups. CONCLUSIONS Our results showed that lack of immediate lymphadenectomy was associated with a higher risk for tumor progression. This preliminary judgement, reinforced by the findings that lymphadenectomy was well tolerated in all cases, and that histopathology provides the definitive assessment of the nodal pathological status, may suggest that prophylactic lymphadenectomy is indicated in the management of stage I MCTs. Larger prospective studies are warranted for generating clinical evidence of this latter hypothesis.
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Affiliation(s)
- Silvia Sabattini
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - Matti Kiupel
- Department of Pathobiology and Diagnostic Investigation, College of Veterinary Medicine, Michigan State University Veterinary Diagnostic Laboratory, East Lansing, USA
| | - Riccardo Finotello
- Department of Small Animal Clinical Science, Institute of Infection, Veterinary and Ecological Science, University of Liverpool, Neston, UK
| | | | - Eugenio Faroni
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | | | | | - Antonella Rigillo
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - Sara Del Magno
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - Armando Foglia
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - Luca Aresu
- Department of Veterinary Sciences, University of Torino, Grugliasco, Torino, Italy
| | - Matteo Gambini
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - Mario Caniatti
- Department of Veterinary Medicine, University of Milan, Milan, Italy
| | - Laura Marconato
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Bologna, Italy.
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Corsini A, Faroni E, Lunetta F, Fracassi F. Recombinant human thyrotropin stimulation test in 114 dogs with suspected hypothyroidism: a cross-sectional study. J Small Anim Pract 2020; 62:257-264. [PMID: 33341942 DOI: 10.1111/jsap.13290] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2020] [Revised: 10/03/2020] [Accepted: 11/26/2020] [Indexed: 12/01/2022]
Abstract
OBJECTIVE To evaluate the performance and define cut-offs for the interpretation of a thyroid-stimulating hormone (TSH) stimulation test with a recombinant human TSH dose of 75 μg/dog administered intravenously in dogs with suspected hypothyroidism. MATERIALS AND METHODS Cross-sectional study. Medical records of dogs presented for suspected hypothyroidism were retrospectively reviewed. Animals were included if a TSH stimulation test with a recombinant human TSH dose of 75 μg/dog was performed and follow-up was available. Dogs with a post-TSH serum total thyroxine (T4) level of ≥2.2 μg/dL were considered euthyroid. Dogs with a post-TSH T4 level of <2.2 μg/dL were classified as hypothyroid or euthyroid based on follow-up, including response to levothyroxine supplementation. A receiver operating characteristic curve analysis was used to define the performance of the test. RESULTS One hundred and fourteen dogs were included. Forty were classified as hypothyroid and 74 as euthyroid. Post-TSH T4 cut-offs of 1.3 and 1.7 μg/dL showed sensitivities of 92.5 and 100% and specificities of 97.3 and 93.2%, respectively. Post-TSH T4 levels of >1.7 μg/dL had a negative predictive value of 100%. Post-TSH T4 levels of <1.3 μg/dL showed a positive predictive value of 94.9%. Area under the ROC curve for post-TSH T4 was 0.99. CLINICAL SIGNIFICANCE A TSH stimulation test performed with a recombinant human TSH dose of 75 μg/dog is highly reliable to discriminate between hypothyroid and euthyroid dogs, even in cases of concurrent non-thyroidal illness or administration of medications. A post-stimulation T4 concentration of >1.7 μg/dL is suggestive of normal thyroid function.
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Affiliation(s)
- A Corsini
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - E Faroni
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - F Lunetta
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Bologna, Italy
| | - F Fracassi
- Department of Veterinary Medical Sciences, University of Bologna, Ozzano dell'Emilia, Bologna, Italy
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15
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Spinelli D, Curatola MR, Faroni E. Comparison between deep sclerectomy with reticulated hyaluronic acid implant and trabeculectomy in glaucoma surgery. Acta Ophthalmol Scand Suppl 2001:60-2. [PMID: 11235543 DOI: 10.1111/j.1600-0420.2000.tb01110.x] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Affiliation(s)
- D Spinelli
- Oculistics Division, Clinical Institutes of Specialization, Milan
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Affiliation(s)
- D Spinelli
- Oculistics Division, Clinical Institutes of Specialization, Milan
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