Retrospective evaluation of thrombocytopenia and tumor stage as prognostic indicators in dogs with splenic hemangiosarcoma

OBJECTIVE To identify physical examination and perioperative CBC variables in dogs with splenic hemangiosarcoma (HSA) that could aid in predicting progression-free interval (PFI) and overall survival time (OST) in affected dogs. ANIMALS 70 client-owned dogs with splenic HSA treated with splenectomy and chemotherapy between September 2004 and October 2016. PROCEDURES A retrospective search of the University of Minnesota Veterinary Medical Center medical records database was performed to identify dogs with splenic HSA treated with splenectomy and with evidence in the medical records of intent to treat with chemotherapy. Data collection included dog signalment and body surface area, results from CBCs performed within 6 days before to 2 days after splenectomy, whether dogs had hemoabdomen or received transfusions, and tumor stage. Hematocrit, WBC count, and platelet count were treated as categorical variables (divided into terciles: above, within, or below reference limits) because of variation among reference intervals for the numerous analyzers used. Associations between variables and PFI or OST were investigated with Cox regression analyses, and hazard ratios (HRs) for a shorter PFI or OST were reported. Population Pearson correlation coefficient (rho) analysis was performed to identify potential associations between variables of interest. RESULTS Stage 3 HSA was identified as a negative prognostic indicator of PFI (HR, 6.6) and OST (HR, 4.5). Perioperative thrombocytopenia was similarly associated with shorter PFI (HR, 2.2) and OST (HR, 2.0). Results for Hct correlated (rho = 0.58) with those for platelet count, and although our findings did not indicate a notable association between anemia and shorter PFI, such could not be ruled out. CONCLUSIONS AND CLINICAL RELEVANCE The prognostic value of thrombocytopenia warrants further substantiation to understand causal and mechanistic connections, and the presence of thrombocytopenia ultimately may prove valuable in guiding treatment recommendations for dogs with splenic HSA.

Automated summary

In dogs with splenic hemangiosarcoma, stage 3 disease and perioperative thrombocytopenia were identified as negative prognostic indicators for progression-free interval and overall survival time. The correlation between hematocrit and platelet count was positive, and while anemia did not show a clear association with shorter PFI, it could not be ruled out. Further research is needed to understand the causal and mechanistic connections of thrombocytopenia and its potential value in guiding treatment recommendations for affected dogs.