医学
肾上腺切除术
危险系数
回顾性队列研究
生存分析
对数秩检验
外科
比例危险模型
内科学
存活率
胃肠病学
置信区间
作者
Matthew M. E. Steele,Marit F. van den Berg,Sara Galac,Ana M. Dordio,Anna Threlfall,Cláudia Maria de Castro Gomes,Amanda St. Paul,Mirja C. Nolff,Nadja S. Sieber‐Ruckstuhl,Ghita Benchekroun,Fergus Allerton,Beatriz Mendoza,Susanna Spence,Paula Valiente,Alisdair M. Boag,Federico Fracassi,Alejandra Carranza Valencia,Jorge Pena‐Ramos,Ben Lloyd‐Bradley,Mayank Seth
摘要
ABSTRACT Background The survival of dogs with pheochromocytoma (PCC) treated with adrenoreceptor antagonists has not been described or compared to surgically managed cases. Hypothesis/Objectives The objective of this study is to evaluate the survival of medically and surgically managed dogs with PCC and investigate factors associated with survival. Animals Two hundred fifty‐five dogs with PCC, treated with alpha‐adrenoreceptor antagonists (AA) without adrenalectomy (Group 1, n = 75), adrenalectomy +/– AA (Group 2, n = 128), or neither treatment (Group 3, n = 52). Methods Retrospective, multicenter review of medical records. Median overall survival time (OST) for Groups 1 and 2 combined was calculated using Kaplan–Meier estimates, and then compared between Group 1 and Group 2 using Log‐Rank testing. Cox proportional hazard analysis identified factors associated with survival in Groups 1 and 2 individually and combined. Results Median OST for all cases was 854 (95% CI: 572–1136) days. Median OST was lower in Group 1 (247 days, 95% CI: 76–418 days) than in Group 2 (927 days, 95% CI: 587–1267 days; p < 0.001). In Group 2, 88/92 dogs (97.8%) that received presurgical AA treatment survived to discharge compared to 23/27 (85.2%) that did not receive AA pretreatment ( p = 0.03). Lack of clinical signs at presentation was associated with increased survival in both groups combined (HR 0.5; 95% CI 0.3–0.9; p = 0.02) and in Group 2 alone (HR 0.3; 95% CI 0.1–0.7; p = 0.01). Conclusions and Clinical Importance Dogs with PCC treated with adrenalectomy have longer survival compared to those managed with AA without adrenalectomy.
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