Rachel Geiger, Joe Mankin, Holger A. Volk, Steven de Decker, Nate van Asselt, Karanbir Randhawa, Tara Ehling, Charles A. Maitz, Ada Naramor, Joan R. Coates, Catherine Stalin, Lauren Johnstone, Joanna Morris, Ioannis N. Plessas, Alexander Forward, Laurent Garosi, Elena Scarpante, Giunio Cherubini, Tom Harcourt-Brown, Sheila Carrera-Justiz, Jishnu Rao Gutti, Marilia Takada, Joel White, Koichi Nagata, Marc Kent, Renee Barber, Daisuke Ito, Tomohiro Nakayama, Ayaka Oshima, Naoki Sekigucki, Lauren Smith-Oskrochi, Nick Jeffery
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Abstract
Background
The comparative effectiveness of radiotherapy and surgery for treating intracranial meningioma is unknown.
Objectives
To compare survival after treatment of suspected intracranial meningioma by either surgery or radiotherapy.
Animals
Two hundred eighty-five companion dogs with suspected intracranial meningiomas presenting to 11 specialty clinics in three countries.
Methods
Parallel cohort comparison study on retrospective data. Dogs diagnosed with intracranial meningioma by board-certified veterinary neurologists or radiologists and treated by radiotherapy or surgery were identified through medical record searches and presenting and survival data extracted. Lesion site was classified as rostro- or caudotentorial and size was measured on contrast magnetic resonance images. Outcome was all-cause death. Analysis of survival by Cox proportional hazards, including selection for optimal multivariable model using lasso, counterfactual modeling including variables associated with treatment allocation and survival.
Results
One hundred sixty-eight dogs received radiotherapy and 117 received surgery. All analyses indicated reduced survival associated with surgery compared to radiotherapy. There was a median survival after surgery of 297 (IQR: 99–768) days compared with 696 (IQR: 368–999) for dogs treated by radiation, associated with a univariable hazard ratio of 1.802 (95% CI: 1.357–2.394). Counterfactual modeling estimated a mean survival of 480 (95% CI: 395–564) days after surgery and 673 (95% CI: 565–782) days after radiotherapy, representing a decrease in survival of 29%. Location and size of the lesion were not associated with survival duration.
Conclusions and Clinical Importance
Dogs with suspected intracranial meningioma have substantially superior survival after radiotherapy compared to surgery.
期刊介绍：
The mission of the Journal of Veterinary Internal Medicine is to advance veterinary medical knowledge and improve the lives of animals by publication of authoritative scientific articles of animal diseases.
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