Abstract
Numerous studies have described the prognostic factors of canine and feline mammary carcinomas (MCs), that is, variables that predict patient survival after diagnosis. But how does survival estimation evolve in patients that escaped early death from their cancer? In human oncology, conditional survival (CS), the probability of surviving X further years when cancer patients have already survived Y years, is used to analyse cancer outcomes in a long‐term perspective. In this cohort of 344 dogs and 342 cats with surgically removed stage I to III invasive MCs, with a minimal follow‐up of 2 years, we calculated the 1‐year CS, that is, the probability for patients that have survived 1 year, to survive or to die from cancer during the subsequent year. The 1‐year conditional specific survival probabilities were 59% and 48% at diagnosis of invasive MC respectively in dogs and cats, and 80% and 52% in 1‐year surviving dogs and cats respectively, suggesting that 1‐year surviving dogs were relatively protected from cancer‐related death, whereas feline MCs remained life‐threatening cancers for longer periods of time. Among the most significant parameters associated with CS in surviving dogs and cats were the nodal stage and lymphovascular invasion, as well as patient age, cancer stage and margin status in surviving dogs. By comparison, tumour size and the histological grade did not significantly alter CS probabilities in surviving dogs and cats. Conditional survival may be considered a very interesting tool for veterinary practitioners to estimate the likely outcome of cancer survivors.
Highlights
Mammary carcinomas (MCs) are among the most common malignant tumours in female dogs and cats, with an annual incidence of 192 MCs for 100 000 dogs[1] and 230 mammary tumours for 100 000 cats, of which 80% to 90% are malignant.[2,3] MCs and, especially, invasive MCs show aggressive behaviour with high metastatic propensity[4,5,6,7] and short survival times after surgical removal.[7,9,10,11] these data are general, and MCs in both dogs and cats show heterogeneity according to numerous factors
In case of multiple/multicentric invasive MCs, the carcinoma with the largest diameter upon histological section was selected for analysis; if tumour size was identical between two MCs in a given patient, the MC with the highest histological grade was considered
This study evaluated the 1-year absolute conditional survival (CS), regarding both all-cause and cancer-specific death, of a large cohort of 344 female dogs and Months after diagnosis Age at diagnosis Pathologic tumour size Pathological nodal stage Histological stage Histological grade Lymphovascular invasion Margin status Ki-67 index Immunophenotype
Summary
Mammary carcinomas (MCs) are among the most common malignant tumours in female dogs and cats, with an annual incidence of 192 MCs for 100 000 dogs[1] and 230 mammary tumours for 100 000 cats, of which 80% to 90% are malignant.[2,3] MCs and, especially, invasive MCs show aggressive behaviour with high metastatic propensity[4,5,6,7] and short survival times after surgical removal (median overall survival of months for dogs[8] and 8 to months for cats with MCs).[7,9,10,11] these data are general, and MCs in both dogs and cats show heterogeneity according to numerous factors. The histological stage,[21,22] surgical margin status,[13,14,23] and immunophenotype[24,25] are robust factors significantly associated with survival probabilities or disease-free interval after diagnosis of invasive MCs. In human oncology and in breast cancer, all of these factors provide prognostic information,[26,27,28,29,30,31,32] given to patients at time of diagnosis using median survival times or 5- and 10-year survival probabilities. The aims of this study were (a) to describe the 1-year absolute overall and cancer-specific CS of female dogs and cats with invasive MCs, and (b) to analyse the influence of epidemiological, clinical, histological and immunohistochemical parameters on this CS
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