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Chemotherapy effectiveness and mortality prediction in surgically treated osteosarcoma dogs: A validation study
A F Schmidt1, M Nielen2, S J Withrow3
1Julius Center for Health Sciences and Primary Care, University Medical Centre Utrecht, P.O. Box 85500, 3508 GA Utrecht, The Netherlands; Division of Pharmacoepidemiology and Clinicl Pharmacology, Utrecht Institute for Pharmaceutical Sciences, P.O. Box 80082, 3508 TB Utrecht, The Netherlands; Department of Farm Animal Health, Faculty of Veterinary Medicine, Utrecht University, Yalelaan 7, 3584 CL Utrecht, The Netherlands; Institute of Cardiovascular Science, Faculty of Population Health, University College London, London WC1E 6BT, UK.
This study validates models predicting canine osteosarcoma mortality risk. Dogs with lower 5-month mortality risk appear to benefit most from chemotherapy after surgery.
Area of Science:
- Veterinary Oncology
- Canine Cancer Research
- Biostatistics
Background:
- Canine osteosarcoma is a prevalent bone cancer in large breeds, leading to significant mortality.
- Previous multivariable models were developed to predict 5-month and 1-year mortality risk post-surgery.
- The models suggested chemotherapy benefits dogs with lower predicted 5-month mortality risk.
Purpose of the Study:
- To externally validate existing multivariable models for predicting mortality risk in canine osteosarcoma.
- To assess the effectiveness of chemotherapy based on predicted mortality risk.
- To confirm the utility of risk prediction models in guiding treatment decisions.
Main Methods:
- External validation using an independent cohort of 794 dogs.
- Comparison of observed versus predicted mortality risks at 5 months and 1 year.
- Analysis of chemotherapy effectiveness as modified by predicted 5-month mortality risk.
Main Results:
- Initial model performance showed some disagreement between predicted and observed risks.
- Model agreement improved after intercept updating for both 5-month and 1-year risks.
- Chemotherapy effectiveness was significantly modified by predicted 5-month mortality risk (P=0.01), favoring dogs with lower risk.
Conclusions:
- The multivariable risk prediction models are validated for predicting canine osteosarcoma patient mortality.
- Dogs with a lower predicted 5-month mortality risk appear to gain the most benefit from adjuvant chemotherapy.
- Risk stratification aids in tailoring treatment strategies for canine osteosarcoma.
