Canine Oral Melanoma

Philip J. Bergman DVM, MS, PhD
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引用次数: 181

Abstract

Melanoma is the most common oral malignancy in the dog. Oral and/or mucosal melanoma has been routinely considered an extremely malignant tumor with a high degree of local invasiveness and high metastatic propensity. Primary tumor size has been found to be extremely prognostic. The World Health Organization staging scheme for dogs with oral melanoma is based on size, with stage I = <2-cm-diameter tumor, stage II = 2- to <4-cm-diameter tumor, stage III = ≥4-cm tumor and/or lymph node metastasis, and stage IV = distant metastasis. Median survival times for dogs with oral melanoma treated with surgery are approximately 17 to 18, 5 to 6, and 3 months with stage I, II, and III disease, respectively. Significant negative prognostic factors include stage, size, evidence of metastasis, and a variety of histologic criteria. Standardized treatments such as surgery, coarse-fractionation radiation therapy, and chemotherapy have afforded minimal to modest stage-dependent clinical benefits and death is usually due to systemic metastasis. Numerous immunotherapeutic strategies have been employed to date with limited clinical efficacy; however, the use of xenogeneic DNA vaccines may represent a leap forward in clinical efficacy. Oral melanoma is a spontaneous syngeneic cancer occurring in outbred, immunocompetent dogs and appears to be a more clinically faithful therapeutic model for human melanoma; further use of canine melanoma as a therapeutic model for human melanoma is strongly encouraged. In addition, the development of an expanded but clinically relevant staging system incorporating the aforementioned prognostic factors is also strongly encouraged.

犬口腔黑色素瘤
黑色素瘤是狗最常见的口腔恶性肿瘤。口腔和/或粘膜黑色素瘤通常被认为是一种具有高度局部侵袭性和高转移倾向的极端恶性肿瘤。原发肿瘤的大小对预后有很大影响。世界卫生组织对患有口腔黑色素瘤的狗的分期方案是基于大小的,I期= 2厘米直径的肿瘤,II期= 2- 4厘米直径的肿瘤,III期=≥4厘米的肿瘤和/或淋巴结转移,IV期=远处转移。接受手术治疗的口腔黑色素瘤狗的中位生存时间分别约为17至18个月,5至6个月和3个月,分别为I, II和III期疾病。重要的不良预后因素包括分期、大小、转移的证据和各种组织学标准。标准化的治疗方法,如手术、粗分割放疗和化疗,只能提供最小到中等程度的分期依赖的临床益处,死亡通常是由于全身转移。迄今为止,已经采用了许多免疫治疗策略,但临床疗效有限;然而,异种DNA疫苗的使用可能代表着临床疗效的飞跃。口腔黑色素瘤是一种自发的同基因癌症,发生在近亲繁殖的免疫能力强的狗身上,似乎是临床上更可靠的人类黑色素瘤治疗模型;强烈鼓励进一步使用犬黑色素瘤作为人类黑色素瘤的治疗模型。此外,我们也强烈鼓励开发一个扩展的但与临床相关的分期系统,将上述预后因素纳入其中。
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