Comparison of perioperative versus postoperative intratumoral administration of cisplatin for treatment of cutaneous sarcoids and squamous cell carcinomas in horses

Alain P. Théon From the Departments of Surgical and Radiological Sciences (Théon, Pascoe, Galuppo), Pathology (Griffey), and Medicine and Epidemiology (Madigan), School of Veterinary Medicine, University of California, Davis, CA 95616-8745, and the Biomedical Imaging Facility, College of Veterinary Medicine, North Carolina State University, Raleigh NC 27602 (Fisher).

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John R. Pascoe From the Departments of Surgical and Radiological Sciences (Théon, Pascoe, Galuppo), Pathology (Griffey), and Medicine and Epidemiology (Madigan), School of Veterinary Medicine, University of California, Davis, CA 95616-8745, and the Biomedical Imaging Facility, College of Veterinary Medicine, North Carolina State University, Raleigh NC 27602 (Fisher).

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Larry D. Galuppo From the Departments of Surgical and Radiological Sciences (Théon, Pascoe, Galuppo), Pathology (Griffey), and Medicine and Epidemiology (Madigan), School of Veterinary Medicine, University of California, Davis, CA 95616-8745, and the Biomedical Imaging Facility, College of Veterinary Medicine, North Carolina State University, Raleigh NC 27602 (Fisher).

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Paul E. Fisher From the Departments of Surgical and Radiological Sciences (Théon, Pascoe, Galuppo), Pathology (Griffey), and Medicine and Epidemiology (Madigan), School of Veterinary Medicine, University of California, Davis, CA 95616-8745, and the Biomedical Imaging Facility, College of Veterinary Medicine, North Carolina State University, Raleigh NC 27602 (Fisher).

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Stephen M. Griffey From the Departments of Surgical and Radiological Sciences (Théon, Pascoe, Galuppo), Pathology (Griffey), and Medicine and Epidemiology (Madigan), School of Veterinary Medicine, University of California, Davis, CA 95616-8745, and the Biomedical Imaging Facility, College of Veterinary Medicine, North Carolina State University, Raleigh NC 27602 (Fisher).

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John E. Madigan From the Departments of Surgical and Radiological Sciences (Théon, Pascoe, Galuppo), Pathology (Griffey), and Medicine and Epidemiology (Madigan), School of Veterinary Medicine, University of California, Davis, CA 95616-8745, and the Biomedical Imaging Facility, College of Veterinary Medicine, North Carolina State University, Raleigh NC 27602 (Fisher).

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Objective

To determine the benefits of reducing the interval between surgical cytoreduction and intratumoral administration of cisplatin.

Design

Randomized clinical study.

Animals

70 horses with 89 incompletely resected T2- and T3-stage sarcoids (n = 64) and squamous cell carcinomas (25).

Procedure

Horses were given 4 intratumoral treatments of cisplatin at 2-week intervals. The first treatment was given at the time of, or immediately after, surgical resection for horses treated in accordance with the perioperative protocol (group 1). Horses in group 2 were treated with cisplatin after the skin healed following surgical resection in accordance with the postoperative protocol.

Results

A difference was not found in duration of overall local tumor control between the 2 groups. Patterns of treatment failures and interval to failure differed between the 2 groups. Length of the surgical scar was the only factor that affected prognosis; an increase in length was associated with a poorer prognosis. A detrimental effect of postoperative treatment was only found in tumors with a high tumor proliferative fraction. Local reactions were similar for the 2 treatment groups, and chronic reactions were not observed.

Conclusions and Clinical Relevance

Intratumoral administration of cisplatin is beneficial for treatment of cutaneous tumors in horses. Tumor repopulation during the interval between surgery and intratumoral administration of cisplatin decreases treatment efficacy. These results provide evidence of rapid tumor repopulation following surgical resection without a lag period for tumors with a high proliferation index. When tumor proliferation index is not known, it may be prudent to use the perioperative protocol. (J Am Vet Med Assoc 1999;215:1655–1660)

Objective

To determine the benefits of reducing the interval between surgical cytoreduction and intratumoral administration of cisplatin.

Design

Randomized clinical study.

Animals

70 horses with 89 incompletely resected T2- and T3-stage sarcoids (n = 64) and squamous cell carcinomas (25).

Procedure

Horses were given 4 intratumoral treatments of cisplatin at 2-week intervals. The first treatment was given at the time of, or immediately after, surgical resection for horses treated in accordance with the perioperative protocol (group 1). Horses in group 2 were treated with cisplatin after the skin healed following surgical resection in accordance with the postoperative protocol.

Results

A difference was not found in duration of overall local tumor control between the 2 groups. Patterns of treatment failures and interval to failure differed between the 2 groups. Length of the surgical scar was the only factor that affected prognosis; an increase in length was associated with a poorer prognosis. A detrimental effect of postoperative treatment was only found in tumors with a high tumor proliferative fraction. Local reactions were similar for the 2 treatment groups, and chronic reactions were not observed.

Conclusions and Clinical Relevance

Intratumoral administration of cisplatin is beneficial for treatment of cutaneous tumors in horses. Tumor repopulation during the interval between surgery and intratumoral administration of cisplatin decreases treatment efficacy. These results provide evidence of rapid tumor repopulation following surgical resection without a lag period for tumors with a high proliferation index. When tumor proliferation index is not known, it may be prudent to use the perioperative protocol. (J Am Vet Med Assoc 1999;215:1655–1660)

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