Klinisch-pathologische Befunde, postoperative Überlebenszeiten und prognostische Faktoren bei Hunden mit primären Lungenkarzinomen

Zusammenfassung

Einleitung Primäre Karzinome der Lunge (PLK) beim Hund sind selten, ihre Behandlung erfolgt chirurgisch. Ziel dieser Studie war die Untersuchung klinisch-pathologischer Befunde, postoperativer medianer Überlebenszeiten (mÜZ) und prognostischer Faktoren.

Material und Methoden Retrospektive Auswertung von 61 Hunden mit 62 PLK, die zwischen 2007 und 2017 chirurgisch behandelt wurden. Die statistische Auswertung erfolgte mittels Kaplan-Meier und Logrank Methoden.

Ergebnisse Von 62 PLKs lagen 35 (56 %) peripher im Lungenlappen, 21 (34 %) hilusnah und 6 (10 %) betrafen den gesamten Lungenlappen. In 49 Fällen lagen differenzierte Adenokarzinome vor; niedrig differenzierte bzw. anaplastische Karzinome (n = 10) und Plattenepithelkarzinome (n = 2) waren deutlich seltener. Eine Prädisposition für bestimmte Lungenlappen war nicht nachzuweisen. Dreizehn (21 %) Patienten zeigten keine und 10 (16 %) nur unspezifische, nicht auf den Respirationstrakt hinweisende Symptome. Insgesamt zeigten 48 (79 %) Hunde klinische Symptome wie Husten, Dyspnoe, Lethargie, Gewichtsverlust, Leistungsschwäche, Erbrechen und/oder Fieber. Die tracheobronchialen Lymphknoten (TBLN) waren in 9 von 51 untersuchten Fällen histologisch positiv für Metastasierung (N1) und negativ (N0) in 42 Fällen (nicht untersucht n = 10). Daten zum Langzeitverlauf waren für 50 Patienten verfügbar. Prognostisch relevante Variablen waren Lymphknotenmetastasierung in die TBLN (mÜZ: N1 41 Tage, N0 570 Tage; p < 0,01), Lungenmetastasen (mÜZ: M1 125 Tage, M0 630 Tage; p < 0,01), histologischer Subtyp (mÜZ: differenzierte Karzinome 620 Tage; andere Karzinome 135 Tage; p < 0,01), Tumordurchmesser größer als 3 cm (mÜZ < 3 cm 1155 Tage, ≥ 3 cm 330 Tage; p = 0,02) und Tumorlokalisation (mÜZ: hilusnah 330 Tage, peripher 650 Tage; p = 0,04).

Schlussfolgerung Beim PLK sind TBLN Status, Organmetastasen, Tumorlokalisation, histologischer Subtyp und Tumorgröße prognostisch relevante Kriterien. Hunde ohne prognostisch negative Faktoren können lange Überlebenszeiten aufweisen. In mehr als einem Drittel der Fälle bleiben die Tumoren asymptomatisch (21 %) bzw. ohne respirationstraktspezifische (16 %) Symptome.

Abstract

Introduction Canine primary pulmonary carcinomas (PLC) are treated surgically. The goal of this study was to increase the veterinary database concerning clinical and pathological findings, postsurgical median survival times (mST), and prognostic factors in this tumor type.

Materials and methods Retrospective analysis of 61 dogs with 62 PLC treated surgically between 2007 and 2017. Survival analyses were performed using the Kaplan-Meier and Logrank methods.

Results Of the 62 tumors, 35 (56 %) were located peripherally in the lung, 21 (34 %) close to the hilus and 6 (10 %) affected the entire lobe. In 49 cases, differentiated (papillary or bronchoalveolar) adenocarcinomas were diagnosed; undifferentiated carcinomas or anaplastic carcinomas (n = 10) and squamous cell carcinomas (n = 2) were rare. There was no predisposition for specific lung lobes. Thirteen (21 %) of the patients exhibited no clinical signs, and 10 (16 %) displayed unspecific signs, unrelated to the respiratory tract. In total, forty-eight (79 %) dogs showed clinical signs such as coughing, dyspnea, lethargy, weight loss, exercise intolerance, vomiting and/or fever. Histologic examination of the tracheobronchial lymph nodes (TBLN), was positive for metastasis (N1) in 9 cases, negative (N0) in 42 patients, no TBLN histology was performed in 10 cases. Long-term follow-up information was available for 50 dogs. Variables with prognostic impact were presence of TBLN metastasis (mST: N1 41 days, N0 570 days; p < 0.01), lung metastases (mST: M1 125 days, M0 630 days; p < 0.01), histologic subtype (mST: tracheobronchial or papillary carcinoma 620 days; other carcinomas 135 days; p < 0.01); tumor diameter larger than 3 cm (mST < 3 cm 1155 days, ≥ 3 cm 330 days p = 0.02), and location of the tumor (mST: hilar 330 days, peripheral 650 days; p = 0.04).

Conclusion In PLK, TBLN status, M1, tumor location, histological subtype and tumor size are important, prognostically relevant factors; dogs without prognostically negative factors may have a good prognosis. More than one third of the dogs present asymptomatically (21 %) or without respiratory signs (16 %).

Schlüsselwörter

Kaniner Lungentumor - Karzinom der Lunge - Chirurgie - Prognose - Chemotherapie

Key words

Canine lung tumor - lung carcinoma - surgery - prognosis - chemotherapy

Publication History

Received: 29 July 2021

Accepted: 21 February 2022

Article published online:
02 November 2022

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