Veterinary Surgical Oncology. Группа авторов

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wall. None of the 18 dogs that received anti‐cancer drugs had remission of the abdominal wall TCC, MST after abdominal wall TCC detection was 57 days. It is crucial to minimize the risk of TCC seeding at surgery. Percutaneous sampling of TCC should be avoided (Higuchi et al. 2013). Radiation: Complications of urinary incontinence and cystitis occur with whole‐bladder intraoperative radiation (Walker and Breider 1987; Withrow et al. 1989). Coarse fractionation external beam radiation (with mitoxantrone‐piroxicam) showed no benefit over mitoxantrone‐piroxicam chemotherapy alone (Poirier et al. 2004b). Laparoscopically implanted tissue‐expander radiotherapy shows promise in reducing radiation damage to surrounding tissues (one dog still alive at 21 months) (Murphy et al. 2008). Neoadjuvant chemotherapy, external beam radiation therapy, and adjuvant chemotherapy were reported in 4 dogs (Marconato et al. 2012). Adaptive radiotherapy techniques spared rectal irradiation and maximized bladder irradiation (Nieset et al. 2014). Intensity‐modulated and image‐guided radiation therapy for treatment of genitourinary carcinomas (bladder, prostate, urethra) in 21 dogs resulted in a MST of 654 days (Nolan et al. 2012). Medical: Mitoxantrone‐piroxicam combination with minimal toxicity has a MST of 291 days (Henry et al. 2003). Cisplatin‐piroxicam is not recommended (Greene et al. 2007). For piroxicam alone, MST is 181 days (Knapp et al. 1994). For deracoxib alone, MST is 323 days (McMillan et al. 2011). Gemcitabine‐piroxicam combination – MST was 230 days (Marconato et al. 2011), and carboplatin‐piroxicam combination –MST was 161 days (Boria et al. 2005), and vinblastine alone, MST 147 days (Arnold et al. 2011). In another study there was no significant difference in MST of dogs treated with mitoxantrone‐piroxicam versus carboplatin‐piroxicam combination; however, dogs with prostatic involvement had shorter MST than TCC in other locations (Allstadt et al. 2015). In 14 dogs treated with cisplatin‐firocoxib combination, the remission rate was 57% and MST 179 days, in 15 dogs treated with cisplatin the remission rate was 13% and MST 338 days, and in 15 dogs treated with firocoxib alone the remission rate was 20% and MST 152 days. Renal and gastrointestinal toxicoses were common in dogs receiving cisplatin or cisplatin/firocoxib (Knapp et al. 2013). In another study of 30 dogs, most of which had failed other treatments, metronomic chlorambucil resulted in partial remission in 1 dog, stable disease in 20 dogs, and progressive disease in 9 dogs. The MST of dogs from the time of the start of chlorambucil treatment was 221 days (Schrempp et al. 2013). Subcutaneous 5‐azacitidine treatment – MST not reported, 18 dogs – partial remission in 4, stable disease in 9, and progressive disease in 4 (Hahn et al. 2012). Intravesical administration of mitomycin C in 13 dogs with bladder TCC – 2 dogs had severe myelosuppression, 5 had partial remission, 7 had stable disease (Abbo et al. 2010). Intralesional interleukin‐2 injected via ultrasound guidance or after surgical debulking in combination with meloxicam, piroxicam, or firocoxib, +/− mitoxantrone resulted in an overall MST of 170 days (Konietschke et al. 2012). Folate‐targeted vinblastine conjugate (EC0905) (investigational). Scintigraphy showed folate uptake in both primary and metastatic lesions, partial remission occurred in 56% of dogs (5 dogs), and stable disease in 44% of dogs (4 dogs) (Dhawan et al. 2013). Intra‐arterial carboplatin chemotherapy may be preferable compared to the intravenous route for rapid reduction in tumor volume, however, follow‐up is short and MST is not reported (Culp et al. 2015). Concurrent antibiotics are commonly needed (Budreckis et al. 2015). PDT: PDT is currently under investigation (Lucroy et al. 2003c; Ridgway and Lucroy 2003). Prostatic carcinoma: Prostatectomy is performed for early‐stage disease confined to prostate capsule (but there is a high rate of urinary incontinence) (Hardie et al. 1984; Basinger et al. 1989). Other treatment modalities include transurethral resection (TUR) (electrosurgical and investigational; relieves urethral obstruction, but 2 of 3 dogs had perforated urethra) (Liptak et al. 2004a); Nd:YAG laser (investigational: 8 dogs had MST of 103 days; 3 died from complications within 16 days) (L'Eplattenier et al. 2006); stenting (investigational but very promising, with good to excellent outcome in 8 dogs) (Weisse et al. 2006); bypass obstruction (prepubic catheter); chemotherapy (investigational); non steroidal anti‐inflammatories (NSAIDs) (MST 6.9 months in 16 dogs, compared to 0.7 months with no cancer therapy in 15 dogs) (Sorenmo et al. 2004b); intraoperative prostatic radiation (MST for 10 dogs was 114 days) (Turrel 1987a); PDT (investigational) (Lucroy et al. 2003a; L'eplattenier et al. 2008); and palliative radiation for skeletal metastasis. One dog with ductus deferens and prostate TCC treated with removal of both ductus deferens and long‐term meloxicam lived for 9 months (Guerin et al. 2012). Cats: Bladder TTC in 11 cats treated with meloxicam had a MST of 311 days (Bommer et al. 2012), in another paper of 20 cats with bladder TCC treated with piroxicam, chemotherapy, or surgery, the MST was 261 days (Wilson et al. 2007). Solitary Primary Lung Mass Surgery (lung lobectomy) is performed, and regional lymph nodes should be biopsied and ideally removed. Clinical stage is an important prognostic indicator with MST 555 days for papillary T₁N_oM_o versus 72 days for the rest (Polton et al. 2008). Lung lobectomy via thoracoscopy reported, smaller tumors are more amenable to thoracoscopic surgery (Mayhew et al. 2013; Bleakley et al. 2015). All adjuvant chemotherapy is investigational at this stage: systemic chemotherapy (vinorelbine) (Poirier et al. 2004a; Wouda et al. 2015); inhalational chemotherapy (Hershey et al. 1999; Vail et al. 2000); intrapleural chemotherapy for malignant pleural effusion (Moore et al. 1991a), a single case report exists of a dog with grade III bronchoalveolar ADC with vascular infiltration and lymph node metastasis treated with tumor removal, chaperone‐rich cell lysate (CRCL) vaccine administered weekly, topical imiquimod for the first 12 treatments, and a single injection of bacillus Calmette‐Guerin (BCG) at week 30 of treatment, with a survival of 50+ weeks post‐diagnosis (Epple et al. 2013). Thymoma Resection is done if possible (89% are resectable) (Gores et al. 1994; Zitz et al. 2008; Robat et al. 2013b), along with chemotherapy (Willard et al. 1980; Aronsohn 1985; Martin et al. 1986; Atwater et al. 1994; Robat et al. 2013b); especially if concurrent megaesophagus relating to a poor surgical candidate; radiation therapy has complete to partial responses, and many also received concurrent surgery or chemotherapy (Hitt et al. 1987; Kaser‐Hotz et al. 2001; Smith et al. 2001; Robat et al. 2013b). Median survival time with and without surgical treatment was 635 and 76 days, respectively, although a small percentage of surgical cases also received chemotherapy and radiation therapy. Recurrent disease after surgery occurred in 15–17%, and prognosis good after second surgery (Zitz et al. 2008; Robat et al. 2013b). Overall MST with surgery alone 790 days (Zitz et al. 2008). Treatment of concurrent myasthenia gravis is accomplished with immunosuppressive and or anti‐cholinesterase therapy, H2 blockers, other supportive care. Portal site metastasis has been reported after thoracoscopic resection of a malignant thymoma in a dog (Alwen et al. 2015). Thymoma‐associated exfoliative dermatitis has been reported in cats and dogs, which resolves with the removal of the thymoma (Forster‐Van Hijfte et al. 1997; Rottenberg et al. 2004; Singh et al. 2010; Tepper et al. 2011; Cavalcanti et al. 2014). Alimentary Esophageal: Palliative PDT for esophageal carcinoma in a dog allowed a 9‐month survival time (Jacobs and Rosen 2000). Esophagogastroscopy and loop electrocautery debulking of an esophageal carcinoma with polypoid hyperplasia resulted in at least a 6‐month ST in one dog, and another dog with esophageal ADC was euthanazed after one week after gastrostomy tube placement due to poor quality of life (Arnell et al. 2013). Stenting of an obstructed esophagus due to SCC resulted in effective palliation for 3 months (Hansen et al. 2012). Primary carcinomas of the esophagus were reported in 2 cats (Gualtieri et al. 1999a).Gastric: Localized gastric carcinoma treated with marginal resection and adjunctive carboplatin chemotherapy is potentially curative (Lee et al. 2014), although partial gastrectomy is usually indicated. It is rare that all local disease is resected and metastasis usually occurs early, leading to a poor prognosis after surgery in most cases. In several studies, the median survival time was only 55 days for 29 dogs with gastric ADC treated with surgery (Fonda et al. 1989; Gualtieri et al. 1999b; Swann and Holt 2002). Small Intestinal: usually solitary intestinal masses, treatment is surgery with wide margins (at least 5 cm), biopsy of liver and lymph node at surgery should be done, adjuvant chemotherapy may be considered. Debilitation and hypoproteinemia may complicate treatment. In a study of 18 cats diagnosed with small intestinal ADC, the MST of cats with ADC that underwent surgery was 365 days versus 22 days for those with that did not undergo surgery,

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