Estudo clínico retrospetivo de Hemangiossarcoma no cão
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2018-02-01
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Com o aumento da esperança média de vida dos animais, cresce também a incidência de doenças relacionadas com a idade. Dentro destas, as neoplasias são uma doença com elevada incidência. O hemangiossarcoma (HSA) é uma neoplasia maligna de origem endotelial vascular, cujo órgão primário mais afetado é o baço e, ocorre com maior frequência nos cães em comparação com as demais espécies. É mais frequente em animais com idades entre oito e treze anos e apresenta sinais, muitas vezes, inespecíficos. Esta neoplasia é diagnosticada recorrendo a vários métodos de diagnóstico clínico, imagiológico e histopatológico, sendo a biopsia seguida de avaliação histopatógica o método de referência. O tratamento de eleição continua a ser a cirurgia associada a protocolos de quimioterapia adjuvante com doxorrubicina, embora nos últimos anos tenham sido efetuados vários estudos com outros fármacos, com a finalidade de melhorar o prognóstico. Este trabalho teve como objetivo o estudo do hemangiossarcoma em cães, na sua índole epidemiológica e clínica, assim como o valor prognóstico das variáveis estudadas. Neste estudo fez-se uma análise retrospetiva das características clinicas de 31 cães diagnosticados com HSA no Centro Hospitalar Veterinário, de 2012 a 2017. A presença de HSA foi mais frequente em cães SRD e em animais da raça Labrador e Boxer. Dos 31 animais incluídos no estudo, a maioria eram machos e de raça indeterminada. A raça Labrador foi a que apresentou maior incidência dentro das raças puras (n=6), seguida das raças boxer (n=4) e Golden Retrivier (n=2). Quando se ajustou a frequência das raças à demografia do hospital, a diferença foi estatisticamente significativa para a raça Labrador (p=0,02), e para a raça Boeiro de Berna (p=0,015), no entanto as outras raças não apresentaram diferença estatística quando comparadas à frequência de raças do CHV. Uma elevada percentagem dos animais desta amostra foram admitidos em choque, com anemia, trombocitopenia e hemoabdómen, no entanto nenhuma destas variáveis demonstrou associação estatística significativa com a Sobrevida Total (p>0,05) nem com a Sobrevida Livre de Doença (p>0,05). O estadiamento clínico, a localização do tumor e o tipo de tratamento a que os animais foram submetidos, também não revelaram associação com o prognóstico na análise da sobrevida (p>0,05). Neste trabalho, obtiveram-se resultados médios de Sobrevida Total de 256 dias e de Sobrevida Livre de Doença de 135 dias, fundamentando a literatura descrita de que este tumor tem mau prognóstico mesmo quando se realiza tratamento multimodal com recurso a cirurgia seguida de quimioterapia. Da realização deste estudo podemos concluir que pelo fato do hemangiossarcoma ser um tumor maligno de comportamento agressivo e elevado potencial metastático, é importante que os médicos veterinários estejam familiarizados com as várias apresentações clínicas, a fim de poderem realizar um diagnóstico atempado desta neoplasia
With the increase in the average life expectancy of animals, an incidence of agerelated diseases is also increasing. Within this, cancer is the pathology with high incidence. Hemangiosarcoma is a malignant neoplasm of vascular endothelial origin. The main primary organ affected is the spleen, and occurs more frequently in dogs compared to other species. It is more frequent in animals with age between 8 and 13 years and clinical signs are often non-specific. This tumor is diagnosed using several clinical exams, in which the biopsy and histopathological findings are the best method of diagnosis. The treatment of choice continues to be the surgery associated with protocols with doxorubicin, in order to improve the prognosis. This paper aimed to study the hemangiosarcoma in dogs, their epidemiological and clinical nature, as well as the prognostic value of the studied variables. In this work, a retrospective analysis was made from the clinical features of 31 dogs diagnosed with HSA at the Centro Hospitalar Veterinário from 2012 to 2017. The presence of HSA was more frequent in mixed breed and in Labrador and Boxer. Of the 31 animals included in the study, the majority were male and mixed race. The Labrador breed was the one with the highest incidence within the pure breeds (n = 6), followed by the boxer breeds (n = 4) and Golden Retrivier (n = 2). When the breed frequency was adjusted to hospital demographics, the difference was statistically significant for the Labrador breed (p = 0.02), and for the Bernese Mountain dog breed (p = 0.015), however the other breeds showed no difference compared to the frequency of CHV’s breeds. A high percentage of the animals in this sample were admitted at the hospital with signs of shock, with anemia, thrombocytopenia and hemoabdomen, but none of these variables showed statistical significance association with Total Survival (p> 0.05) or Disease Free Survival (p> 0 , 05). Clinical staging, tumor location and type of treatment to which the animals were submitted also showed no association with prognosis in survival analysis (p> 0.05). In this study, mean results of 256-day Total Survival and 135-day Disease Free Survival were obtained. Based on the literature described, this tumor has poor prognosis even when performing multimodal treatment with surgery followed by chemotherapy. From this study we can assume that hemangiosarcoma is a malignant tumor with aggressive behavior and high metastatic potential. It is important that veterinarians stand familiar with the various clinical presentations in order to be able to make a timely diagnosis of this tumour.
With the increase in the average life expectancy of animals, an incidence of agerelated diseases is also increasing. Within this, cancer is the pathology with high incidence. Hemangiosarcoma is a malignant neoplasm of vascular endothelial origin. The main primary organ affected is the spleen, and occurs more frequently in dogs compared to other species. It is more frequent in animals with age between 8 and 13 years and clinical signs are often non-specific. This tumor is diagnosed using several clinical exams, in which the biopsy and histopathological findings are the best method of diagnosis. The treatment of choice continues to be the surgery associated with protocols with doxorubicin, in order to improve the prognosis. This paper aimed to study the hemangiosarcoma in dogs, their epidemiological and clinical nature, as well as the prognostic value of the studied variables. In this work, a retrospective analysis was made from the clinical features of 31 dogs diagnosed with HSA at the Centro Hospitalar Veterinário from 2012 to 2017. The presence of HSA was more frequent in mixed breed and in Labrador and Boxer. Of the 31 animals included in the study, the majority were male and mixed race. The Labrador breed was the one with the highest incidence within the pure breeds (n = 6), followed by the boxer breeds (n = 4) and Golden Retrivier (n = 2). When the breed frequency was adjusted to hospital demographics, the difference was statistically significant for the Labrador breed (p = 0.02), and for the Bernese Mountain dog breed (p = 0.015), however the other breeds showed no difference compared to the frequency of CHV’s breeds. A high percentage of the animals in this sample were admitted at the hospital with signs of shock, with anemia, thrombocytopenia and hemoabdomen, but none of these variables showed statistical significance association with Total Survival (p> 0.05) or Disease Free Survival (p> 0 , 05). Clinical staging, tumor location and type of treatment to which the animals were submitted also showed no association with prognosis in survival analysis (p> 0.05). In this study, mean results of 256-day Total Survival and 135-day Disease Free Survival were obtained. Based on the literature described, this tumor has poor prognosis even when performing multimodal treatment with surgery followed by chemotherapy. From this study we can assume that hemangiosarcoma is a malignant tumor with aggressive behavior and high metastatic potential. It is important that veterinarians stand familiar with the various clinical presentations in order to be able to make a timely diagnosis of this tumour.
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hemangiossarcoma , cão , epidemiologia , prognóstico