Investigation of the utility of lymph node fine‐needle aspiration cytology for the staging of malignant solid tumors in dogs

Fournier, Quentin; Cazzini, Paola; Bavčar, Špela; Pecceu, Evi; Ballber, Clara; Elders, Richard

doi:10.1111/vcp.12636

Cited by 39 publications

(54 citation statements)

References 40 publications

(114 reference statements)

Supporting

Mentioning

Contrasting

Order By: Relevance

“…11 Sensitivity of lymph node cytology ranged from 63% to 75% in detecting lymph node metastasis of melanomas, sarcomas and mast cell tumours when compared to extirpated lymph nodes in a recent study. 11 For virtually all malignant solid tumours, the metastatic status of the lymph node is one of the most important prognostic indicators of poor survival and governs therapeutic options. 12 The detection of sentinel lymph nodes in veterinary medicine has previously been described with the use of various imaging modalities including contrast radiographic studies, lymphoscintigraphy, contrast-enhanced ultrasonography and with the use of indirect CT lymphography.…”

Section: Introductionmentioning

confidence: 98%

The development of an indirect computed tomography lymphography protocol for sentinel lymph node detection in head and neck cancer and comparison to other sentinel lymph node mapping techniques

Randall

Jones

Kraft

et al. 2020

Vet Comparative Oncology

View full text Add to dashboard Cite

Identification of metastatic disease critically impacts the care and prognosis of patients with neoplasia. Multiple techniques exist for identifying the sentinel or first lymph node(s) that receive draining tumour lymph. Identification of the sentinel lymph node enables accurate tissue sampling for determination of lymphatic metastasis. The aims of this study were to develop a computed tomography (CT) protocol for identifying the sentinel lymph node in dogs with tumours of the head and neck. In addition, indirect CT lymphography was compared to lymphoscintigraphy and vital dye injection to determine which technique more reliably identified the sentinel lymph node. CT indirect lymphography using intratumoral injection of iodinated contrast identified draining lymphatic vessels in eight of 18 dogs and identified the sentinel lymph node in five of 18 dogs. CT indirect lymphography employing fourquadrant peritumoral injection of iodinated contrast identified draining lymphatic vessels in 18 of 20 dogs and identified the sentinel lymph node in 11 of 20 dogs. Vital dye injection and lymphoscintigraphy identified the sentinel lymph node in 17 of 18 and 20 of 20 dogs, respectively. Identified sentinel lymph nodes were either ipsilateral or bilateral to the primary tumour. Both CT techniques were found to be safe and simple. Peritumoral injection has the greatest promise for the detection of sentinel lymph nodes in various head and neck cancers using CT, while lymphoscintigraphy had the greatest success of the compared techniques.

show abstract

Section: Introductionmentioning

confidence: 98%

The development of an indirect computed tomography lymphography protocol for sentinel lymph node detection in head and neck cancer and comparison to other sentinel lymph node mapping techniques

Randall

Jones

Kraft

et al. 2020

Vet Comparative Oncology

View full text Add to dashboard Cite

show abstract

“…Ultrasound or CT guidance may aid in the cytologic sampling of the less accessible retropharyngeal and parotid lymph nodes (RLN and PLN, respectively), depending on operator experience and comfort ( 10 ). Conversely, several veterinary oncologic studies have shown that cytology alone also lacks sensitivity and specificity in the evaluation of potential metastasis to regional lymph nodes ( 3 , 16 , 17 ). Thus, histopathologic evaluation of the draining regional lymph nodes at risk for metastasis remains the gold standard diagnostic staging tool for dogs with oral tumors ( 3 , 8 , 10 , 11 , 16 , 17 ).…”

Section: Introductionmentioning

confidence: 99%

Variability in Recommendations for Cervical Lymph Node Pathology for Staging of Canine Oral Neoplasia: A Survey Study

2020

View full text Add to dashboard Cite

There is no clear guideline regarding the indication for routine lymph node extirpation and pathologic evaluation during staging of canine oral tumors, despite a relatively high reported nodal metastatic rate for select tumor types. It is particularly unclear if clinicians recommend removal of lymph nodes only when there is confirmation of metastasis, defined as the N+ neck, or if elective neck dissection (END) is routinely recommended to confirm the true pathologic metastatic status of lymph nodes in the clinical N0 neck (no evidence of metastasis on clinical staging with diagnostic imaging or cytology). When clinicians are recommending END as a staging tool to confirm nodal status, there is also ambiguity regarding the surgical extent for subsequent histopathologic evaluation. The objective of this cross-sectional survey study was to determine the current recommendations given by practicing specialists regarding lymph node removal for dogs with oral tumors. Overall, 87 responses were obtained from 49 private practices (56%) and 38 academic institutions (44%). Respondents identified as oncologists (44%, N = 38), soft tissue surgeons (40%, N = 35), and dentists (16%, N = 14). Regardless of tumor type and stage, extirpation and histopathology were most commonly recommended in the clinical N+ neck only. The recommendation to routinely perform END in the N0 neck was significantly associated with tumor type. Bilateral removal of the mandibular and retropharyngeal lymph nodes was recommended more often for oral malignant melanoma (OMM) than for oral squamous cell carcinoma (OSCC; p ≤ 0.0039) or for oral fibrosarcoma (OFSA; p ≤ 0.0007). The likelihood of recommending END increased with increasing tumor size. Academic clinicians were significantly ( p < 0.01) more likely to recommend END compared to private practitioners for canine T1–T3 OMM, T3 OSCC, T2 OFSA, and MCT. This study highlights the variability in recommendations for lymph node pathology for dogs with oral tumors. While tumor type and size influenced the decision to pursue END, it was not routinely recommended, even for tumor types with a known propensity for metastasis. Prospective studies are warranted to determine the potential diagnostic and therapeutic value of END in the N0 neck in veterinary patients such that a consensus approach can be made.

show abstract

“…10,11 With a reported 75% sensitivity of fine-needle aspiration cytology (FNAC) to detect MCT nodal metastasis, LN extirpation has also been recommended to complete MCT staging. 12,13 Lymphadenectomy is an invasive procedure that often necessitates additional surgical preparation and time, extending time under anaesthesia for dogs and costs for owners. It is therefore sometimes difficult to justify when the LN draining status is uncertain and/or when the LN is particularly difficult to remove.…”

mentioning

confidence: 99%

Contrast‐enhanced ultrasound for sentinel lymph node mapping in the routine staging of canine mast cell tumours: A feasibility study

Fournier

Thierry

Longo

et al. 2020

Vet Comparative Oncology

Self Cite

View full text Add to dashboard Cite

Canine mast cell tumours (MCTs) typically spread to lymph nodes (LNs) before reaching distant sites, and LN assessment is an important part of MCT staging. Sentinel LN (SLN) mapping techniques to identify draining LNs are being developed and could improve the accuracy of MCT staging. The primary objective of this feasibility study was to determine the safety and effectiveness of contrast-enhanced ultrasound (CEUS) to identify SLNs. Secondary objectives were to determine if the SLNs identified by CEUS coincided with the regional LN predicted by the anatomical lymphosomes, if previous MCT excision altered CEUS SLN findings, and if CEUS could identify MCT nodal metastases. Between June 2017 and March 2019, 59 dogs with 62 MCTs were enrolled. No adverse events related to CEUS were reported. CEUS detected at least 1 SLN in 59/62 MCTs (95.2%, 95% CI: 86.5-99.0%). In only 32/59 (54.2%) MCTs, clinicians would have correctly predicted the SLN(s) identified by CEUS. Among the 35 MCTs that had histological examination of the SLN(s), the prevalence of metastasis was 60% (95% CI: 42.1-76.1%). Additional staging procedures did not reveal any metastases in dogs with histologically non-metastatic SLNs. Integration of CEUS SLN mapping into the routine staging of MCTs is promising, but future studies are required to refine this procedure and to investigate if it would translate into a clinical benefit.

show abstract

Investigation of the utility of lymph node fine‐needle aspiration cytology for the staging of malignant solid tumors in dogs

Abstract: 23Background: Fine needle aspiration cytology (FNAC) of lymph nodes (LNs) is routinely

Cited by 39 publications

References 40 publications

The development of an indirect computed tomography lymphography protocol for sentinel lymph node detection in head and neck cancer and comparison to other sentinel lymph node mapping techniques

The development of an indirect computed tomography lymphography protocol for sentinel lymph node detection in head and neck cancer and comparison to other sentinel lymph node mapping techniques

Variability in Recommendations for Cervical Lymph Node Pathology for Staging of Canine Oral Neoplasia: A Survey Study

Contrast‐enhanced ultrasound for sentinel lymph node mapping in the routine staging of canine mast cell tumours: A feasibility study

Contact Info

Product

Resources

About