Spirocerca lupi induced oesophageal neoplasia: Predictors of surgical outcome

Abstract

Canine spirocercosis is caused by the nematode Spirocerca lupi. Migration results in oesophageal fibro-inflammatory nodules that may undergo neoplastic transformation. No studies have assessed pre- or post-surgical prognostic indicators in dogs that undergo intervention for S. lupi induced oesophageal neoplasia. This observational, multi-center study aimed to assess the outcome of dogs with Spirocerca induced sarcoma undergoing endoscopic-guided ablation (n = 12) or surgery (n = 18), and identify prognostic indicators. Parameters evaluated included: age, weight, gender, presenting complaints, duration of clinical signs, complete blood count, serum biochemistry, neoplasia size, placement of percutaneous endoscopically-placed gastrostomy tube, histopathological mitotic indices, days to discharge and chemotherapy administration. Kaplan-Meier survival curves showed no difference in survival between ablation and surgery {(median: 73.5 days (range: 0-1511) vs. 108 days (range: 0-1550), respectively (p = 0.982)}. Reduced survival was documented in patients presenting with weight loss (P = 0.027), hypochromasia (MCHC <33 g/dL, P = 0.023) or leucocytosis (>15 × 10/L, P = 0.017) with a hazard ratio of 2.51 (CI = 1.071-6.018, P = 0.034), 2.71 (CI = 1.10-6.65, P = 0.03) and 4.39 (CI: 1.21-15.97, P = 0.025) respectively. In the dogs surviving more than 21 days, Ht <36% and leucocytosis >15.0 × 10/L at presentation were associated with reduced survival (p = 0.016, p = 0.021 respectively) and hazard ratio of 3.29 (CI = 1.18-9.2, P = 0.023) and 3.81 (CI = 1.15-12.55, P = 0.028) respectively. Intra-intervention-group survival analysis identified increased survival time in dogs receiving chemotherapy, but only within the surgical group (P = 0.02).The hospitalisation time of dogs undergoing ablation (median: 0 days, range: 0-4) was significantly shorter than dogs undergoing surgery (9 days, 1-21) (P < 0.001). In this study, no clear benefit was identified for surgery, thus when ablation is technically possible it should be considered advantageous, as hospitalisation time is significantly shorter. Weight loss, hypochromasia and leucocytosis were identified as long-term prognostic indicators at presentation.

Postmortem detection and histopathological features of canine spirocercosis-induced putative esophageal chondrosarcoma

“…Percentage of gastrointestinal system associated clinical manifestations (33%) is highly evident among spirocercosis dogs according to our retrospective study ( Table-1 ). This finding is consistent with other reports which emphasized regurgitation and/or vomiting as common clinical signs in dogs with spirocercosis [ 6 - 8 ].…”

“…The association between spirocercosis and neoplasia was first reported in the 1950s [ 6 ] with numerous subsequent reports in the literature during the 1960s-1970s [ 1 , 9 , 10 ]. The incidence of esophageal fibrosarcoma and osteosarcoma is relatively high in S. lupi endemic areas [ 11 ].…”

Gastro‐oesophageal resection and anastomosis for an oesophageal leiomyoma in a dog

“…Reported cases are old aged, and no apparent gender or breed predilection has been identified. In tropical regions that have higher incidence of Spirocera lupi , dogs are predisposed to secondary oesophageal sarcoma formation 8,19–21 . In regions with low incidence of S. lupi , squamous cell carcinomas, leiomyosarcomas, and leiomyomas are the most common types of canine oesophageal neoplasms 22 …”

“…In tropical regions that have higher incidence of Spirocera lupi, dogs are predisposed to secondary oesophageal sarcoma formation. 8,[19][20][21] In regions with low incidence of S. lupi, squamous cell carcinomas, leiomyosarcomas, and leiomyomas are the most common types of canine oesophageal neoplasms. 22 In dogs, leiomyomas have been reported to occur throughout the gastrointestinal tract, although they are the most common benign tumours of the stomach.…”

Spirocerca lupi Proteomics and Its Role in Cancer Development: An Overview of Spirocercosis-Induced Sarcomas and Revision of Helminth-Induced Carcinomas

“…S. lupi has been associated with the formation of sarcomas in canids, with reports of the malignant transformation of esophageal nodules in approximately 25% of infected dogs, with osteosarcoma and fibrosarcoma comprising the most common diagnoses [ 6 , 17 , 18 ]. Other types of S. lupi -induced sarcomas are chondrosarcoma [ 19 ] and undifferentiated sarcoma [ 7 ].…”