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. 2024 May-Jun;38(3):1675-1685.
doi: 10.1111/jvim.16997. Epub 2024 Mar 1.

Weishaar's classification system for nodal metastasis in sentinel lymph nodes: Clinical outcome in 94 dogs with mast cell tumor

Damiano Stefanello  1 , Elisa M Gariboldi  1 , Patrizia Boracchi  2 , Roberta Ferrari  1 , Alessandra Ubiali  1 , Donatella De Zani  1 , Davide D Zani  1 , Valeria Grieco  1 , Chiara Giudice  1 , Camilla Recordati  1 , Mario Caniatti  1 , Luigi Auletta  1 , Lavinia E Chiti  1   3
Affiliations

Weishaar's classification system for nodal metastasis in sentinel lymph nodes: Clinical outcome in 94 dogs with mast cell tumor

Damiano Stefanello et al. J Vet Intern Med. 2024 May-Jun.

Abstract

Background: The therapeutic role and prognostic relevance of lymphadenectomy in mast cell tumor (MCT) has historically been evaluated on regional rather than sentinel lymph nodes.

Hypothesis/objectives: To update information about the association of histological nodal (HN) classes with clinical outcome in dogs with MCT after tumor excision and extirpation of normal-sized sentinel nodes (SLN) guided by radiopharmaceutical.

Animals: Ninety-four dogs with histologically-confirmed treatment-naïve MCT (71 cutaneous, 22 subcutaneous and 1 conjunctival MCT) were included if without: distant metastases, lymphadenomegaly, concurrent mixed cutaneous, and subcutaneous MCT.

Methods: This was a monoistitutional cohort study. Tumors characteristics were retrieved and SLNs were classified according to Weishaar's system. Incidence of MCT-related events (local, nodal, distant relapse), de novo MCT or other tumors and death (MCT-related and non-MCT-related), were recorded. Incidence curves were compared among the HN classes.

Results: Twenty-seven dogs had HN0, 19 HN1, 37 HN2, and 11 HN3 SLN. Thirteen (2 HN0, 4 HN2, and 7 HN3) received adjuvant chemotherapies. Kiupel high grade, increasing number of SLN and lymphocentrums were associated with higher HN classes. Five dogs died for MCT-related causes: 1 low-grade (HN0) and 1 subcutaneous (HN3) had a local relapse, 2 high-grade had distant relapse (HN3-HN0) and 1 dog developed disease progression from a de novo subcutaneous MCT. No nodal relapse was registered. Fourteen dogs developed de novo MCTs.

Conclusion/discussion: Low grade/low-risk MCT with nonpalpable and normal sized SLN have a favorable outcome independently from the HN. Result should be considered strictly related to the successful SLN detection guided pre- and intraoperative by radiopharmaceutical markers.

Keywords: canine; mapping; mast cell; prognosis; surgery.

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Conflict of interest statement

Authors declare no conflict of interest.

Figures

FIGURE 1
FIGURE 1
Cumulative incidence of different neoplastic events (relapse, de novo MCT, and other tumors different from MCT). Dashed line: local relapse (LR); dotted line: distant metastasis (DM); continue line: de novo MCT; line‐dot line: other tumors different from MCT.
FIGURE 2
FIGURE 2
Cumulative incidence of MCT disease (composite end‐point with target events: local relapse, nodal relapse, distant metastases, and de novo MCTs) in each HN classes. Continue line: HN0; dashed line: HN1; dotted line: HN2; line‐dot line: HN3.
FIGURE 3
FIGURE 3
Cumulative incidence of MCT disease (composite end‐point with target events: local relapse, nodal relapse, distant metastases, and de novo MCTs) in dogs with and without adjuvant chemotherapy treatment. Continue line: without chemotherapy; dashed line: with chemotherapy.
FIGURE 4
FIGURE 4
The incidence of death from all causes (MCT‐related and non‐MCT‐related), for each HN classes. Continue line: HN0; dashed line: HN1; dotted line: HN2; line‐dot line: HN3.
See this image and copyright information in PMC

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