P. Pazzi1; A. Kavkovsky2; A. Shipov2; G. Segev2; E. Dvir3
Canine spirocercosis is caused by the nematode Spirocerca lupi. Oesophageal fibro-inflammatory nodules may undergo neoplastic transformation. No studies assessed pre- or post-surgical prognostic indicators in dogs that undergo intervention.
This observational multi-center study aimed to assess the outcome of dogs with neoplastic spirocercosis undergoing endoscopic-guided ablation (n=12) or surgery (n=18), and identify prognostic indicators. Parameters evaluated included: age, weight, body condition score at diagnosis, gender, duration of clinical signs, hematology, biochemistry, tumor size, placement of percutaneous endoscopically placed gastrostomy tube, histopathological mitotic indices, days to discharge and chemotherapy administration.
Kaplan-Meier survival curves showed no difference in survival between ablation and surgery [median: 68 days (range: 0–1550) vs. 107 days (0–1511), respectively (p=0.662)]. When only dogs surviving the first 21 days (T21) after ablation or surgery were evaluated, the significance in survival was borderline [79 days (45–1550) vs. 250 days (80–1511), respectively, p=0.082]. None of the parameters measured were associated with survival advantage. Intra-treatment group survival analysis identified survival advantage for chemotherapy within the surgical group (p=0.021); this became insignificant (p=0.430) in T21. When the latter were evaluated, Ht >36% (p=0.016) and white cell count <15.0x109/L at presentation (p=0.021) were associated with an improved outcome. Ht <36% at presentation for all dogs and T21 showed a significant hazard ratio (0.960, p=0.037 and 0.947, p=0.022 respectively).
No clear benefit was identified for surgery, when ablation is technically possible. Prognostic indicators were only useful if the dog survived the first 21 days post-surgery. Chemotherapy post-intervention made no difference to survival.
Disclosures
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