Veterinary Surgical Oncology E-Book

• Herausgeber: John Wiley & Sons
• Kategorie: Fachliteratur
• Sprache: Englisch

Seitenzahl: 1829

Veröffentlichungsjahr: 2012

Beschreibung

Veterinary Surgical Oncology provides in-depth coverage of surgical techniques for treating cancer in small animal patients. Organized by body system, each chapter presents detailed, well-illustrated descriptions of surgical procedures, with additional information on diagnostic testing, aftercare, outcomes, and prognosis. Edited and authored by members of the Veterinary Society of Surgical Oncologists, Veterinary Surgical Oncology's comprehensive coverage of surgical treatments for cancer provides an invaluable decision-making tool and is equally useful for veterinary surgeons and veterinary oncologists. The book begins with introductory chapters on the principles of surgical oncology, multimodal therapy, and interventional radiology, then presents chapters on surgical techniques in all anatomical structures, including procedures not well covered in existing literature. The first book to focus on the surgical aspects of cancer treatment, Veterinary Surgical Oncology is an essential reference for anyone with an interest in surgical oncology.

Leseprobe

Table of Contents

Cover

Title page

Copyright page

Dedication

List of Contributors

Preface

1 Principles of surgical oncology

Preoperative Considerations

Surgical Planning

Postoperative Considerations

2 Multimodal therapy

3 Interventional oncology

Imaging

Instrumentation and Implants

Approaches

Nonvascular Interventional Oncology Techniques

Vascular Interventional Oncology Techniques

4 Skin and subcutaneous tumors

Skin Tumors General Principles

General Approach to the Diagnosis and Staging of Skin Tumors

Mast Cell Tumors

Mesenchymal Tumors and Melanoma

5 Head and neck tumors

Lymph Node Staging

Nasal Planum Tumors

Tumors of the Pinna

Tumors of the External Ear Canal

Tumors of the Middle Ear

Salivary Gland Tumors

Tumors of the Lip

6 Oral tumors

Introduction

Diagnosis and Clinical Staging

General Surgical Considerations

Surgical Approach to Tumors of the Mandible

Surgical Approach to Tumors of the Maxilla

Mandibular and Maxillary Tumors in Dogs

Surgical Approach to Tumors of the Hard Palate

Surgical Approach to Tumors of the Tongue

Multimodal Management of Oral Tumors

Prognosis

7 Alimentary tract

Esophagus

Stomach

Liver and Gallbladder

Pancreas

Small Intestine

Colorectal Tumors

Perianal Tumors

8 Respiratory tract and thorax

Rhinotomy

Laryngeal Tumors

Thoracotomy

Tracheal Tumors

Lung

Metastasectomy for Sarcomas

Thoracic Wall Resection

9 Cardiovascular system

Heart and Heart-Base Tumors

Pericardial Tumors

Carotid Body Tumors

Vascular Oncologic Surgery—Tumor Emboli Excision

10 Reproductive system

Female Reproductive System

Male Reproductive System

11 Urinary tract

Biopsy Procedures for Urinary Tumors

Imaging Techniques

Kidney

Ureters

Bladder

Urethra

12 Eyelids, eye, and orbit

Introduction

Clinical Workup and Biopsy Principles

Imaging Techniques

Eyelid Neoplasia

Conjunctival, Nictitans, and Scleral Neoplasia

Eye Neoplasia

Orbital Neoplasia

13 Endocrine system

Pituitary Tumors

Adrenal Tumors

Thyroid Tumors: Feline Hyperthyroidism

Thyroid Glands: Canine Thyroid Tumors

Parathyroid Tumors

Endocrine Pancreatic Tumors

14 Hemolymphatic system

Spleen

Thymus

Lymph Nodes

Lymphatics

15 Nervous system

Brain and Calvarial Tumors

Spinal Tumors

Peripheral Nerve Sheath Tumors

16 Musculoskeletal system

Skeletal Tumors

Joint Tumors

Muscle Tumors

Adjuvant and Other Therapies

Index

This edition first published 2012 © 2012 by John Wiley & Sons, Ltd.

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Library of Congress Cataloging-in-Publication Data

Veterinary surgical oncology / [edited by] Simon T. Kudnig, Bernard Séguin ; illustrations by Dave Carlson.

p. ; cm.

 Includes bibliographical references and index.

 ISBN-13: 978-0-8138-0542-9 (hardcover : alk. paper)

 ISBN-10: 0-8138-0542-2 (hardcover : alk. paper)

 ISBN-13: 978-0-4709-6321-0 (epdf)

 ISBN-13: 978-0-4709-6322-7 (epub)

 ISBN-13: 978-0-4709-6323-4 (mobi)

 I. Kudnig, Simon T. II. Séguin, Bernard, 1968–

 [DNLM: 1. Neoplasms–surgery. 2. Neoplasms–veterinary. 3. Surgery, Veterinary–methods. SF 910.T8]

 LC classification not assigned

 636.089'7–dc23

2011032156

A catalogue record for this book is available from the British Library.

Wiley also publishes its books in a variety of electronic formats. Some content that appears in print may not be available in electronic books.

Disclaimer

The publisher and the author make no representations or warranties with respect to the accuracy or completeness of the contents of this work and specifically disclaim all warranties, including without limitation warranties of fitness for a particular purpose. No warranty may be created or extended by sales or promotional materials. The advice and strategies contained herein may not be suitable for every situation. This work is sold with the understanding that the publisher is not engaged in rendering legal, accounting, or other professional services. If professional assistance is required, the services of a competent professional person should be sought. Neither the publisher nor the author shall be liable for damages arising herefrom. The fact that an organization or Website is referred to in this work as a citation and/or a potential source of further information does not mean that the author or the publisher endorses the information the organization or Website may provide or recommendations it may make. Further, readers should be aware that Internet Websites listed in this work may have changed or disappeared between when this work was written and when it is read.

To my wife Narelle, my parents Philip and Judy, my brother Martin, and my sister Mandy for their unending support and understanding, and to my daughter Samantha for the joy and perspective on life you have brought.

S.K.

To my wife Lisa, my parents Gisèle and René, and my brother Jean-François for their encouragement, support, and love and to my children Alexandre and Gabrielle, for being my inspiration and teaching me so much more.

B.S.

To Dr. Stephen J. Withrow for teaching us, among many other things: “Success is the ability to move forward in the face of failure.”

S.K. and B.S.

List of Contributors

Sara A. Ayres, DVM, DVSc, Diplomate ACVS

Surgeon, Simcoe Veterinary Surgical Referral

Ontario, Canada

Head and Neck Tumors

Nicholas J. Bacon, MA, VetMB, CertVR, CertSAS, Diplomate ECVS, Diplomate ACVS

Clinical Assistant Professor, Surgical Oncology

University of Florida College of Veterinary Medicine

Gainesville, Florida, USA

Urinary Tract

Tania A. Banks, BVSc, FACVSc

Lecturer, Small Animal Surgery

The School of Veterinary Science, The University of Queensland

Gatton Campus, QLD, Australia

Multimodal Therapy

Alimentary Tract: Pancreas

Sarah Boston, DVM, DVSc, Diplomate ACVS

Assistant Professor, Small Animal Surgery (Surgical Oncology)

Department of Clinical Studies

Ontario Veterinary College, University of Guelph, Guelph, ON, Canada

Respiratory Tract and Thorax: Chest Wall Tumors, Laryngeal Tumors, Tracheal Tumors

Tara A. Britt, VMD, Diplomate ACVS

Veterinary Surgical Services

Veterinary Referral Center of Colorado

Englewood, CO, USA

Reproductive System: The Male

Lisa Brownlee, DVM, MS, Diplomate ACVIM (Internal Medicine)

Assistant Professor, Department of Clinical Sciences

College of Veterinary Medicine, Oregon State University

Corvallis, OR, USA

Endocrine System

Paolo Buracco, DVM, Diplomate ECVS

Professor of Veterinary Surgery

School of Veterinary Medicine

Grugliasco, Turin, Italy

Alimentary Tract: Colorectal Tumors and Perianal Tumors

Earl F. Calfee, III, DVM, MS, Diplomate ACVS

Nashville Veterinary Specialists

Nashville, TN, USA

Alimentary Tract: Stomach, Liver and Gall Bladder, Pancreas, Small Intestine

Elaine R. Caplan, DVM, Diplomate ACVS, Diplomate ABVP

Texas Veterinary Oncology, Capital Area Veterinary Specialists, Inc.

Austin, TX, USA

Nervous System

Ryan P. Cavanaugh, DVM, Diplomate ACVS

Staff Surgeon, VCA Alameda East Veterinary Hospital

Denver, CO, USA

Alimentary Tract: Stomach, Liver and Gall Bladder, Pancreas, Small Intestine

William T.N. Culp, VMD, Diplomate ACVS

Assistant Professor, Small Animal Surgery (Surgical Oncology/Interventional Radiology), Department of Surgical and Radiological Sciences

School of Veterinary Medicine, University of California, Davis

Davis, CA, USA

Principles of Surgical Oncology

Interventional Oncology

Alimentary Tract: Esophagus

Michael Davidson, DVM, Diplomate ACVO

Professor, Ophthalmology; Associate Dean and Director of Veterinary Medical Services

College of Veterinary Medicine, North Carolina State University

Raleigh, NC, USA

Eyelids, Eye, and Orbit

William S. Dernell, DVM, MS, Diplomate ACVS

Professor and Chair, Department of Veterinary Clinical Sciences

College of Veterinary Medicine, Washington State University

Pullman, WA, USA

Musculoskeletal System

Nicole Ehrhart, VMD, MS, Diplomate ACVS

Professor, Surgical Oncology, Department of Clinical Sciences

College of Veterinary Medicine and Biomedical Sciences, Colorado State University

Fort Collins, CO, USA

Principles of Surgical Oncology

James P. Farese, DVM, Diplomate ACVS

Associate Professor, Surgical Oncology, Department of Small Animal Clinical Sciences

College of Veterinary Medicine, University of Florida

Gainesville, FL, USA

Urinary Tract

Musculoskeletal System

Jolle Kirpensteijn, DVM, PhD, Diplomate ACVS, Diplomate ECVS

Professor, Surgery, Department of Clinical Sciences of Companion Animals

Faculty of Veterinary Medicine, Utrecht University

Utrecht, The Netherlands

Skin and Subcutaneous Tumors: Skin Tumors General Principles, Soft Tissue Sarcomas

Simon T. Kudnig BVSc, MVS, MS, FACVSc, Diplomate ACVS

Staff Surgeon, Melbourne Veterinary Specialist Centre

Melbourne, Victoria, Australia

Cardiovascular System

B. Duncan X. Lascelles, BSc, BVSc, PhD, CertVA, DSAS(ST), Diplomate ECVS, Diplomate ACVS

Professor of Surgery and Pain Management, Surgery Section and Comparative Pain Research Laboratory

North Carolina State University College of Veterinary Medicine

Raleigh, NC, USA

Oral Tumors

Eyelids, Eye, and Orbit

Julius M. Liptak, BVSc, MVetClinStud, FACVSc, Diplomate ACVS, Diplomate ECVS

Specialist Small Animal Surgeon, Alta Vista Animal Hospital

Ottawa, Ontario, Canada

Head and Neck Tumors

Oral Tumors

Musculoskeletal System

Marina Martano, DMV, PhD

Assistant Professor of Veterinary Surgery

School of Veterinary Medicine, University of Turin

Grugliasco (TO), Italy

Respiratory Tract and Thorax: Thoracotomy, Rhinotomy

Eric Monnet, DVM, PhD, Diplomate ACVS, Diplomate ECVS

Professor, Small Animal Surgery, Department of Clinical Sciences

Colorado State University College of Veterinary Medicine and Biomedical Sciences

Fort Collins, CO, USA

Cardiovascular System

Emanuela Morello, DMV, PhD

Assistant Professor of Veterinary Surgery

School of Veterinary Medicine, University of Turin

Grugliasco (TO), Italy

Respiratory Tract and Thorax: Lung.

Stewart Ryan, BVSc, MS, Diplomate ACVS

Assistant Professor, Musculoskeletal and Surgical Oncology, Department of Clinical Sciences

College of Veterinary Medicine and Biomedical Sciences

Colorado State University

Fort Collins, CO, USA

Skin and Subcutaneous Tumors: Skin Tumors General Principles, Mast Cell Tumors

Bernard Séguin, DVM, MS, Diplomate ACVS

Associate Professor, Department of Clinical Sciences

College of Veterinary Medicine, Oregon State University

Corvallis, OR, USA

Endocrine System

Maurine J. Thomson, BVSc, FACVSc

Specialist, Surgical Oncologist

Veterinary Specialist Services, Springwood Centre

Underwood, Qld, Australia

Reproductive System: The Female

Sebastiaan van Nimwegen, DVM, PhD

Department of Clinical Sciences of Companion Animals

Faculty of Veterinary Medicine, Utrecht University

Utrecht, The Netherlands.

Skin and Subcutaneous Tumors: Skin Tumors General Principles, Soft Tissue Sarcomas

Peter J. Walsh, DVM, MVetSc, Diplomate ACVS

Veterinary Specialty Group

West Sacramento, CA, USA

Endocrine System

Christine C. Warzee, DVM, Diplomate ACVS

Assistant Professor, Surgical Oncology

Center for Comparative Oncology, College of Veterinary Medicine

Michigan State University

East Lansing, MI, USA

Hemolymphatic System

Stephen J. Withrow, DVM, Diplomate ACVS, Dipomate ACVIM (Oncology)

University Distinguished Professor, Surgical Oncology, Department of Clinical Sciences

College of Veterinary Medicine and Biomedical Sciences, Colorado State University

Fort Collins, CO, USA

Respiratory Tract and Thorax: Metastasectomy for Sarcomas

Deanna R. Worley, DVM, Diplomate ACVS

Assistant Professor, Surgical Oncology, Department of Clinical Sciences

College of Veterinary Medicine and Biomedical Sciences, Colorado State University

Fort Collins, CO, USA

Musculoskeletal System

Erik G.H. Wouters, DVM

Department of Clinical Sciences of Companion Animals

Faculty of Veterinary Medicine, Utrecht University

Utrecht, The Netherlands

Skin and Subcutaneous Tumors: Skin Tumors General Principles, Soft Tissue Sarcomas

Preface

This book is the result of the collaboration between many contributors who belong to the Veterinary Society of Surgical Oncology (VSSO). At its inception, the impetus to write this book was to help fulfill the goals of the VSSO, which include “to disseminate knowledge to help provide the highest possible standard of surgical treatment for cancer and to encourage and promote education in surgical oncology for professional veterinary students, graduate students and house officers, and graduated veterinarians and veterinary surgeons” (www.vsso.org/aims.html).

The field of surgical oncology has greatly expanded in recent years. The creation of the VSSO reflects this growth. The idea of the VSSO was the brainchild of Dr. Steve Withrow. Dr. Withrow is, for many of us, the pioneer of surgical oncology in veterinary medicine, and he instituted the first fellowship in veterinary surgical oncology in 1988. Many of the original members of the VSSO are graduates of the fellowship. Under the leadership of Dr. Julius Liptak, the VSSO was officially created in 2006. In the first year of the VSSO, there were less than 30 members, whereas at the time of publication there are more than 235. Members are from North America, Europe and the United Kingdom, Australia and New Zealand, and Asia.

The American College of Veterinary Surgeons (ACVS) has announced that it will recognize further training and expertise in certain fields of surgery, one of which is oncologic surgery. This is affirmation of the expanding body of knowledge in surgery in general as well as that focusing on a certain field is necessary to remain the most proficient. The recognition of advanced training in a field will best promote continued development of novel ideas that will increase our understanding of the diseases and their treatment. We hope this textbook will serve as a repository of knowledge for anyone with an interest in surgical oncology to use and to build upon in the future.

The emphasis of this book is on the surgical aspect of treating small animals afflicted by cancer. This book is not meant to be a full review of small animal oncology as there are several excellent existing textbooks doing so. For instance, this book was not meant to be a comprehensive review of how to diagnose the diseases. Rather, we wanted to concentrate on the surgical procedures, such as those that are not well covered in the literature. Our goal is to assist decision making and to cover controversies in the field. The reader is expected to have a basic knowledge of general surgical principles and surgical techniques.

We are indebted to all the contributors for their remarkable contributions. The excellence of the chapters is to their credit and not ours, but any errors are our responsibility. We want to thank Erin Gardner, Erica Judisch, Nancy Turner, Erin Magnani and Susan Engelken from Wiley-Blackwell for their assistance and patience during this whole process, which was for the most part new to both of us. We also want to thank Jane Loftus for copy-editing the chapters; and Dave Johnson and Lorie Kennerly from the Information Technology Services at the College of Veterinary Medicine, Oregon State University, for their assistance when needed. We also thank Jill Bartlett from Oregon State University and Jean-François Séguin for their technical assistance with some of the figures. We need to thank our colleagues, house officers, students, and staff for their support and the motivation they supplied. And most importantly, we thank our families who by extension and default have lived through the creation of this book. Without their support and understanding, this would not have been possible.

We hope you find this book helpful in your practice and education and welcome any comments you may have.

Simon T. Kudnig and Bernard Séguin

1

Principles of surgical oncology

Nicole Ehrhart, William T.N. Culp

Cancer treatment is a rapidly changing and evolving area involving the use of multiple diagnostic and therapeutic modalities to achieve the most optimal outcome. Surgical intervention remains a pivotal aspect of the treatment of cancer. Surgery cures more cancer than any other single modality. Nonetheless, the optimal treatment pathway for any given animal patient with cancer most often involves several adjuvant treatment modalities. Adjuvant treatments significantly affect the success of surgery, and likewise, surgery affects the outcome of adjuvant treatments. It is widely recognized in human cancer centers that patient outcome is greatly improved when surgery is performed by a surgeon with specialized training in oncologic procedures. These surgeons have expertise in selecting surgical treatment options in combination with other forms of cancer treatment, as well as knowledge of the benefits and risks associated with a multidisciplinary approach beyond that which can be mastered within a 3-year surgery residency training program. This level of expertise requires an understanding of the fundamental biology of cancer, clinical pharmacology, tumor immunology and endocrinology, as well as a thorough understanding of potential complications of multimodality therapy. Veterinary training programs in surgical oncology have been in existence for the last 14 years. With the development of new treatments such as small molecule inhibitors, gene therapy, and new forms of radiation, the role of the surgical oncologist is constantly evolving and changing (O’Reilly et al. 1997; Drixler et al. 2000).

Therapeutic goals (e.g., curative intent, cytoreduction, or palliation) for each case should be established with the pet owners before surgery is initiated. The efficacy of surgical therapy in any patient with cancer is heavily dependent upon the surgeon’s global understanding of the patient’s general health status, lifestyle, and activity level; type and stage of cancer; adjuvant therapies available; alternatives to surgery; and expected prognosis. To maximize effectiveness, the optimal treatment pathway for each case should be strategically assessed before initiating treatment. This planning should always include a frank and thorough discussion with the owner regarding preoperative diagnostic tests, stage of cancer, palliative options, surgical options, adjuvant treatments likely to be needed, costs, postoperative care, and expected function, cosmesis and prognosis including risks of complications. The goal of this discussion is to provide owners with enough information to help them make an informed choice regarding the best treatment plan for their companion. Highly individualized initial planning will allow for the best overall outcome for each patient.

Preoperative Considerations

Signalment

The patient’s age, gender, breed, and weight are important factors in the determination of appropriate recommendations. Advanced age is not necessarily a negative prognostic factor. Comorbidities common to geriatric veterinary patients such as renal insufficiency, hepatic disease, or osteoarthritis may limit or change specific treatment recommendations; however, the age of the patient alone should not.

Certain neoplastic diseases are common in a particular gender or breed. The surgical oncologist should always bear in mind the role that gender and breed play in the diagnosis of neoplasia. As an example, the differential list for a flat-coated retriever with a femoral bony lesion noted on radiographs that has been referred for a suspected diagnosis of osteosarcoma should be expanded to include histiocytic sarcoma; other diagnostics such as an abdominal ultrasound would be recommended to look for other foci of histiocytic disease.

Other portions of the signalment are also important to note, including the patient’s weight and body condition. Patients that are morbidly obese or those in poor body condition may not be able to function effectively or may be more severely debilitated by a major surgery. For example, a patient with cancer cachexia can have such profound alterations of their carbohydrate, protein, and fat metabolism that recovery may be compromised (Ogilvie 1998).

Staging and Concomitant Disease

Staging diagnostics such as a complete blood count, chemistry profile, urinalysis, thoracic radiographs, and abdominal ultrasound are essential components for the preoperative assessment of veterinary oncology patients. While there is debate about the timing of some of these diagnostics (i.e., before or after biopsy), for many patients thorough preoperative staging diagnostics can unmask an underlying condition that may alter the plan or better assist the surgeon to provide a more accurate prognosis. Alternative surgical dose may also be recommended based on the results of staging.

Neoadjuvant Therapy