PubMed · 6867920
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E M Burgess. 1983. Amputations.. https://doi.org/10.1016/s0039-6109(16)43040-9
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Acute necrotizing fasciitis is a rare but frequently catastrophic infection of the subcutaneous tissues and fascial sheaths. It is rare in infants and children. The case of a 3 1/2-year-old boy with acute necrotizing fasciitis caused by group A beta hemolytic streptococcus is described.
Malignant digital tumors were diagnosed in 62 dogs during a 1-year period. Twenty-one (33.9%) of the dogs had subungual squamous cell carcinoma. Each of these dogs had involvement of single digits. Sixteen (76.2%) of the dogs with squamous cell carcinoma were large-breed dogs, and 15 (71.4%) had predominantly black coats. Labrador Retrievers (n = 5, 23.8%) and Standard Poodles (n = 3, 14.3%) were the most commonly represented purebreeds. None of the dogs had evidence of metastases prior to treatment. All 21 tumors were treated by amputation of the involved digit. Histologic evidence of neoplastic bone invasion was found in 15 of the 21 amputated digits (71.4%). Local tumor recurrences were not observed. Only 1 dog developed documented metastatic disease; this dog was euthanatized because of pulmonary metastases 5 months after surgery. At the time of this report, 9 dogs (42.9%) were alive with no evidence of disease (median, 26 months after surgery), and 11 dogs (52.4%) had died or were euthanatized (median, 20 months after surgery). The cause of death in 7 dogs was known to be unrelated to squamous cell carcinoma, and the cause of death in 4 dogs was unknown. The 1-year and 2-year survival rates were 76.2% and 42.9%, respectively.
Twenty-two dogs with appendicular osteosarcoma were treated by amputation (n = 17) or limb-sparing surgery (n = 5). All dogs were given cisplatin (60 mg/m2 of body surface, IV) at 3-week intervals, beginning 1 week after surgery. Number of cisplatin treatments ranged from 1 to 6. Survival data for the 22 dogs were compared with survival data from a historical control group consisting of 162 dogs with appendicular osteosarcoma treated by amputation alone. Median survival time for the 22 dogs given cisplatin was estimated to be 46.4 weeks, and 1- and 2-year survival rates were estimated to be 45.5 and 20.9%, respectively. Survival time was significantly (P less than 0.0001) longer for treated dogs than for control dogs. Statistically significant relation was not found between survival time and number of cisplatin treatments. Three dogs were alive with no evidence of disease at the time of reporting. Of the remaining 19 dogs, 14 (73.4%) were euthanatized for problems documented to be related to metastases. Nine (47.4%) dogs were euthanatized because of bone metastases, and 5 (26.3%) were euthanatized because of pulmonary metastases. The proportion of dogs euthanatized because of bone metastases was significantly (P less than 0.0001) higher for treated than for control dogs. Median survival times for dogs developing bone and lung metastases were estimated to be 51.2 weeks and 21.2 weeks, respectively; however, this difference was not statistically significant. One local tumor recurrence was observed among dogs that had limb-sparing surgery. Significant difference in survival time was not observed between dogs that had limb-sparing surgery and dogs that underwent amputation.