Impacto da tomografia computorizada versus radiografia no prognóstico pós-cirúrgico do carcinoma espinocelular oral no cão
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Data
2012
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Objectivos: Neste estudo retrospectivo pretendeu-se determinar o impacto da tomografia
computorizada na sobrevivência pós-cirúrgica do cão com carcinoma espinocelular na
cavidade oral, comparativamente à radiografia. Enfatizando desta forma, a sua importância
no diagnóstico, no planeamento cirúrgico e prognóstico. O segundo objectivo consistiu em
determinar as características tomográficas dos carcinomas espinocelulares da cavidade oral
em cães.
Material e Métodos: Foram analisados 7 canídeos com diagnóstico de carcinoma
espinocelular. Os critérios de inclusão foram: cães com carcinoma espinocelular
diagnosticado por biópsia, exame imagiológico complementar (radiografia simples ou
tomografia computorizada), elegibilidade para cirurgia, execução de tratamento cirúrgico e
acompanhamento pós-cirúrgico durante 2 anos. Foi registada a idade, o sexo, a raça, a
localização anatómica, o estadiamento T e N, as características radiográficas e tomográficas
dos tumores, o tempo de recorrência e por fim o tempo de sobrevivência global descrito nos
registos consultados. Procedeu-se também ao registo das variáveis das imagens
radiográficas e tomográficas obtidas: definição das margens neoplásicas, presença ou
ausência de reacção perióstea e de destruição de osso cortical adjacente, presença de
deslocação dentária e de reabsorção dentária e densidade óssea local.
Resultados: Nenhum dos meios imagiológicos permitiu uma visualização bem definida das
margens neoplásicas. A nível da destruição de osso cortical adjacente, foi visível em 66,67%
dos casos avaliados com radiografia e em todos os casos que foram avaliados com
tomografia computorizada (100%). Foi visível reacção perióstea em 33,33% dos canídeos
avaliados por radiografia e em nenhum dos avaliados por tomografia (0%). A densidade
óssea local estava diminuída em todos os casos avaliados por radiografia simples ou por
tomografia. A nível de reabsorção dentária estava presente em 33,33% dos avaliados por
radiografia e em 25% dos avaliados por tomografia. Foi possível visualizar deslocação
dentária em 66,67% dos avaliados por radiografia e em todos os avaliados por tomografia
(100%). A nível de percentagem de casos com recorrência local, nenhum caso avaliado com
radiografia recorreu e apenas 1 caso avaliado por tomografia recorreu em 289 dias. O tempo
médio de sobrevivência foi superior no grupo dos avaliados com radiografia (1091,7 dias)
relativamente ao grupo avaliado por tomografia (404 dias). Ao fim de 2 anos, 66,67% dos
casos avaliados por radiografia estavam vivos e somente 25% dos casos avaliados com
tomografia sobreviveram.
Discussão/conclusão: Não foi possível determinar o impacto real dos dois meios de
diagnóstico no prognóstico pós-cirúrgico do carcinoma espinocelular oral no cão, devido à
reduzida amostra e aos tumores com pior prognóstico (por localização e estadiamento)
terem sido remetidos para tomografia.
Objectives: This retrospective study aims to determine the impact of CT on post-surgical survival in the dog with oral squamous cell carcinoma, emphasizing their importance in diagnosis, surgical treatment and prognosis. Second objective aim was to determine tomographic and radiographic features of oral squamous cell carcinoma. Methods and materials: In this study 7 dogs were analysed with oral squamous cell carcinoma. The inclusion criteria were dogs with diagnosis of oral squamous cell carcinoma by biopsy and imaging examination (x-ray or computed tomography), eligibility for surgery and post-surgical follow-up for 2 years. The following criteria were registered: age, gender, breed; location, T and N staging, x-ray and tomography features of the tumors, as well as survival time obtained from the records. From x-ray and tomography analisys it was also registered definition of tumor margins, presence of destruction of the adjacent cortical bone, periosteal reaction, movement or dental resorption, as well as the bone density. Results: None of the supplementary diagnostic procedures used achieved well-defined neoplastic margins (0%). With x-ray, destruction of adjacent cortical bone was observed in 66,67% of cases, while tomography showed it in all cases (100%). Also for cases assessed by computed tomography, periosteal reaction was not visible in none of the cases (0%), while it was observed in 33,3% of the x-ray cases. All cases had a decrease in bone density (x-ray and tomography). Displacement of tooth was visible in 66,67% of the cases assessed by x-ray and in 100% for cases assessed by computed tomography. Dental resorption was seen in 33,33% of the cases assessed by x-ray and 25% of the cases assessed by computed tomography. Local recurrence was registered in 1 case assessed by tomography (in 289 days), while none of the cases assessed by x-ray recurred. The median survival time was superior in cases assessed by x-ray (1091,7 days) when compared with those assessed by computed tomography (404 days). Only 66,67% of the dogs assessed by x-ray were alive at the end of 2 years, and only 25% of the cases assessed by tomography were alive until that moment. Discussion/conclusion: This retrospective study failed the objective of determining the real impact of tomography and x-ray on post-surgical prognosis of oral squamous cell carcinoma in dogs, due to the small sample and the fact that tumours with worse prognosis (by localization and staging) were always evaluated by tomography.
Objectives: This retrospective study aims to determine the impact of CT on post-surgical survival in the dog with oral squamous cell carcinoma, emphasizing their importance in diagnosis, surgical treatment and prognosis. Second objective aim was to determine tomographic and radiographic features of oral squamous cell carcinoma. Methods and materials: In this study 7 dogs were analysed with oral squamous cell carcinoma. The inclusion criteria were dogs with diagnosis of oral squamous cell carcinoma by biopsy and imaging examination (x-ray or computed tomography), eligibility for surgery and post-surgical follow-up for 2 years. The following criteria were registered: age, gender, breed; location, T and N staging, x-ray and tomography features of the tumors, as well as survival time obtained from the records. From x-ray and tomography analisys it was also registered definition of tumor margins, presence of destruction of the adjacent cortical bone, periosteal reaction, movement or dental resorption, as well as the bone density. Results: None of the supplementary diagnostic procedures used achieved well-defined neoplastic margins (0%). With x-ray, destruction of adjacent cortical bone was observed in 66,67% of cases, while tomography showed it in all cases (100%). Also for cases assessed by computed tomography, periosteal reaction was not visible in none of the cases (0%), while it was observed in 33,3% of the x-ray cases. All cases had a decrease in bone density (x-ray and tomography). Displacement of tooth was visible in 66,67% of the cases assessed by x-ray and in 100% for cases assessed by computed tomography. Dental resorption was seen in 33,33% of the cases assessed by x-ray and 25% of the cases assessed by computed tomography. Local recurrence was registered in 1 case assessed by tomography (in 289 days), while none of the cases assessed by x-ray recurred. The median survival time was superior in cases assessed by x-ray (1091,7 days) when compared with those assessed by computed tomography (404 days). Only 66,67% of the dogs assessed by x-ray were alive at the end of 2 years, and only 25% of the cases assessed by tomography were alive until that moment. Discussion/conclusion: This retrospective study failed the objective of determining the real impact of tomography and x-ray on post-surgical prognosis of oral squamous cell carcinoma in dogs, due to the small sample and the fact that tumours with worse prognosis (by localization and staging) were always evaluated by tomography.
Descrição
Orientação : Lisa Mestrinho ; co-orientação : Nuno Cardoso
Palavras-chave
VETERINÁRIA, CANÍDEOS, CANIDS, MESTRADO INTEGRADO EM MEDICINA VETERINÁRIA, CÃES, DOGS, NEOPLASIAS, NEOPLASMS, TOMOGRAFIAS, TOMOGRAPHIES, RAIOS X, X-RAYS, PROGNÓSTICOS, PROGNOSIS, ANÁLISE DE SOBREVIVÊNCIA, SURVIVAL ANALYSIS, MEDICINA VETERINÁRIA, VETERINARY MEDICINE