Outcomes of cats treated with maxillectomy: 60 cases. A Veterinary Society of Surgical Oncology retrospective study

Abstract

Maxillectomy is poorly described for the management of oral tumours in cats and is occasionally not recommended because of the high complication rate and sub‐optimal outcome reported in cats treated with mandibulectomy. The purpose of this study was to retrospectively evaluate the complications and oncologic outcome in cats treated with maxillectomy. Sixty cats were included in the study. Maxillectomy procedures included unilateral rostral (20.0%), bilateral rostral (23.3%), segmental (10.0%), caudal (20.0%) and total unilateral maxillectomy (26.7%). Intra‐operative and post‐operative complications were reported in 10 (16.7%) and 34 (56.7%) cats, respectively. The most common post‐operative complications were hyporexia (20.0%) and incisional dehiscence (20.0%). The median duration of hyporexia was 7 days. Benign tumours were diagnosed in 19 cats (31.7%) and malignant tumours in 41 cats (68.3%). Local recurrence and metastatic rates were 18.3% and 4.9%, respectively; the median progression‐free interval (PFI) was not reached. The disease‐related median survival time was not reached overall or for either benign or malignant tumours. The 1‐ and 2‐year survival rates were, respectively, 100% and 79% for cats with benign tumours, 89% and 89% for cats with malignant tumours, 94% and 94% for cats with fibrosarcomas, 83% and 83% for cats with squamous cell carcinomas, and 80% and 80% for cats with osteosarcomas. Poor prognostic factors included mitotic index for PFI, adjuvant chemotherapy for both PFI and survival time, and local recurrence for survival time. Maxillectomy is a viable treatment option for cats resulting in good local tumour control and long survival times.

Feline Oral Squamous Cell Carcinoma: A Critical Review of Etiologic Factors

“…In general, feline oral squamous cell carcinoma (FOSCC) grows fast and is locally invasive, causing destruction of oral tissues [ 1 , 2 ]. The survival rate of cats affected by oral SCC has not improved over recent decades and the prognosis remains poor independently of the treatment instituted [ 3 , 4 , 5 , 6 , 7 ]. Considering the similarities in incidence, tumor biology, therapy, and prognosis, FOSCC has been proposed as a spontaneous model for human head and neck squamous cell carcinoma (HNSCC) [ 8 , 9 ].…”

Characterization of the genetic landscape of feline oral squamous cell carcinoma

“…Treatment of FOSCC is first surgical removal from the oral cavity, if feasible. In contrast to some other cat cancer types, FOSCC surgery is often followed by high recurrence rates with estimates ranging from 15.4 to 38% [86][87][88] . Other standards of treatment following surgery include, radiation, and chemotherapy; but again poor outcomes are the result 89,90 .…”

A quantitative evaluation of DNA damage from irradiation of feline oral squamous cell carcinoma cells

“…15 Most recently, the Veterinary Society of Surgical Oncology conducted a multi-institutional retrospective study of outcome and complications in 60 cats that were treated with a maxillectomy. 7 Even though 56.7% of cats experience post-operative complications, this number was considered acceptable when considering the adverse reactions to other treatments for feline oral tumors. 7 Far fewer cats necessitated feeding tube placement than what was required with mandibulectomies, and all cats resumed voluntary feeding.…”

“…7 Even though 56.7% of cats experience post-operative complications, this number was considered acceptable when considering the adverse reactions to other treatments for feline oral tumors. 7 Far fewer cats necessitated feeding tube placement than what was required with mandibulectomies, and all cats resumed voluntary feeding. 7 Most notable was the improved 1-and 2-year survival rates of 83% for cats with squamous cell carcinoma, which may be multifactorial resulting from better local control, adjuvant chemotherapy or radiation therapy, or selection bias.…”

“…4 This cancer carries a poor prognosis with a one-year survival rate of less than 10%, often because tumors are at an advanced at diagnosis; however, advances in multimodality treatment have shown an improvement in median survival times with some cats experiencing durable remissions one to six years beyond initial tumor treatment. [6][7][8][9][10] Apart from the stochastic risk of genetic mutations that can lead to the development of cancer, risk factors for oral squamous cell carcinoma (SCC) in cats have been identified.…”