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Evaluation of lung lobectomy and adjuvant treatment for primary pulmonary carcinoma in dogs: 89 cases (2005–2022)

E. Treggiari, G. Romanelli, P. Valenti, V. Montinaro, M. Rossanese

Background
Primary pulmonary carcinoma in dogs, particularly of epithelial origin, is a relatively rare but significant neoplasm, often diagnosed in older dogs with variable clinical presentations. While prior studies have examined various histotypes, this study focused specifically on the outcomes of dogs undergoing lung lobectomy for epithelial pulmonary carcinoma, aiming to clarify prognostic indicators and the potential role of adjuvant chemotherapy.

Methods
This was a retrospective, multicentre study involving 89 dogs that underwent lung lobectomy for histologically confirmed epithelial pulmonary carcinoma between 2005 and 2022. Inclusion required thoracic CT staging, surgical intervention, histopathological diagnosis, and a minimum six-month follow-up. Data on clinical signs, tumour characteristics, treatment details, and outcomes were collected and analyzed using univariate and multivariate Cox regression models.

Results
The median survival time (MST) for all dogs was 252 days, with a progression-free interval (PFI) of 140 days. Survival was significantly shorter in dogs with tumours ≥5 cm (MST 284 vs. 717 days) and those with lymph node metastasis (MST 162 vs. 614 days). Chemotherapy did not significantly affect survival overall, but maximum tolerated dose (MTD) chemotherapy yielded longer MST compared to metronomic therapy or TKIs (364 vs. 249 days). Clinical signs, pleural effusion, surgical margin status, and histopathological grade or aggressiveness did not significantly influence survival, although trends toward better outcomes were noted in asymptomatic dogs and those with complete excision.

Limitations
Major limitations include the retrospective design, variability in staging and treatment approaches, and incomplete lymph node sampling, potentially underestimating metastatic rates. Additionally, tumour grading was inconsistently reported, limiting its utility as a prognostic factor.

Conclusions
Lung lobectomy offers potential for prolonged survival in dogs with primary pulmonary carcinoma, particularly in those with tumours <5 cm and no lymph node involvement. The prognostic value of adjuvant chemotherapy remains uncertain, warranting further prospective studies to better define its role in managing aggressive or metastatic disease.

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