Objective: The optimal surgical technique for treatment of cranial cruciate ligament rupture in canine has been scientifically discussed for decades. Despite the continuous debate, proximal tibial osteotomies such as tibial plateau leveling osteotomy (TPLO) and tibial tuberosity advancement (TTA) are increasingly common. The objective of this review was to systematically evaluate the literature reporting outcome and complications associated with TPLO and TTA. Materials and methods: A systematic search of literature databases identified articles published from August 2004 to February 2016 describing evaluations of short- or longterm outcomes as well as complications following TPLO or TTA. Results: Ninety-one studies were included in this review and assigned to one out of four evidence levels. Of those, 89 studies provided the lowest evidence level and only two were assigned to the third-best evidence level. A comparison of subjective gait analyses could not detect differences in the decrease of lameness between TPLO and TTA, while objective gait analysis supports the superiority of TPLO. Fewer patients treated with TPLO were diagnosed with postoperative joint instability and TPLO had a lower percent increase of osteoarthritis (OA) after surgery. Owner satisfaction was high for both techniques. For TPLO and TTA the average total, minor, major and catastrophic complication rates were 15.9 % and 20.8 %, 7.9 % and 11.6 %, 5.2 % and 13.2 % as well as 0.8 % and 5.6 %, respectively. Conclusion and clinical significance: The assessed literature supports the hypothesis that TPLO is associated with lower complication rates, an improved clinical-functional outcome and less increase of OA compared to TTA. The results are indicative for a long-term restoration of normal limb function after TPLO. However, the strength of available evidence and the comparability of each study’s results were poor and more comparative studies are needed to draw strong conclusions towards the superiority of the TPLO over the TTA. Gegenstand und Ziel: Die optimale chirurgische Technik zur Behandlung der Ruptur des vorderen Kreuzbands beim Hund ist seit Jahrzehnten ein viel diskutiertes Thema in der Kleintierorthopädie. Trotz anhaltender Diskussionen werden Osteotomietechniken der Tibia, die Tibial Plateau Leveling Osteotomy (TPLO) und das Tibial Tuberosity Advance ment (TTA), immer häufiger angewendet. In diesem Artikel werden die in der Literatur beschriebenen Ergebnisse und Komplikationen nach einer TPLO und TTA systematisch zusammengefasst und verglichen. Material und Methoden: Nach systematischer Literaturrecherche zu klinischen Studien über TPLO oder TTA wurden zwischen August 2004 und Februar 2016 publizierte Studien inkludiert, die über Kurz- oder Langzeitergebnisse und Komplikationen berichteten. Ergebnisse: Die 91 analysierten Studien wurden einer von vier Evidenzklassen zugeteilt. Zwei Studien entsprachen der drittbesten Evidenzklasse, 89 der niedrigsten Evidenzklasse. Ein Vergleich der Ergebnisse subjektiver Lahmheitsuntersuchungen zeigte keine eindeutigen Unterschiede zwischen den Techniken. Objektive Ganganalysen wiesen auf bessere Resultate nach TPLO hin. Die TPLO war mit einer geringeren postoperativen Zunahme der Osteoarthritis (OA) verbunden und bei weniger Patienten wurde postoperativ eine Gelenkinstabilität diagnostiziert. Die durchschnittlichen Gesamtkomplikationsraten betrugen für die TPLO und TTA 15,9 % bzw. 20,8 %, die gering-, mittel- und hochgradigen Komplikationsraten 7,9 % bzw. 11,6 %, 5,2 % bzw. 13,2 % sowie 0,8 % bzw. 5,6 %. Schlussfolgerung und klinische Rele vanz: Aktuelle Publikationen stützen die Hypothese, dass die TPLO mit besseren klinisch-funktionellen und radiologischen Ergebnissen, einer geringeren Zunahme der OA sowie geringeren Komplikationsraten einhergeht. Die Resultate der Studie lassen auf eine Lang-zeitwiederherstellung der normalen Giedmaßenfunktion nach einer TPLO schließen. Zu beachten sind jedoch das niedrige Evidenzniveau und die limitierte Vergleichbarkeit der Resultate verschiedener Studien. Um eindeutige Aussagen bezüglich der Überlegenheit der TPLO gegenüber der TTA ziehen zu können, bedarf es weiterer Vergleichsstudien.

Lymph node status is an important prognostic factor in multiple oncologic conditions in humans and companion animals. In addition, the resection of the affected nodes can have a substantial therapeutic effect on various cancer subtypes in both species. Given the impact on prognosis and management, it is paramount to identify and remove affected nodes. While this can be achieved by removing predefined patterns of nodes (regional lymphadenectomy/resection of defined lymphatic stations), modern approaches increasingly utilize sentinel node mapping to identify the draining nodes to decrease the mortality of lymphadenectomies. Recent studies have shown that dogs have more comparable anatomy of the lymphatic system to humans than other animal models such as rodents or pigs. Given the fact that dogs develop spontaneous cancer types that share several similarities to their human counterparts, they represent a valuable translational model. The management of the lymphatic basin and sentinel node mapping have gained increased attention in veterinary surgical oncology in recent years. The present review aims at summarizing the resulting findings and their impact on patient management.

Introduction: Complete surgical tumor resection is paramount in the management of soft tissue sarcoma (STS) in humans, dogs, and cats alike. Near-infrared targeted tracers for fluorescence-guided surgery (FGS) could facilitate intraoperative visualization of the tumor and improve resection accuracy. Target identification is complicated in STS due to the rarity and heterogeneity of the disease. This study aims to validate the expression of fibroblast activation protein alpha (FAP) in selected human, canine, and feline STS subtypes to assess the value of FAP as a target for FGS and to validate companion animals as a translational model.Methods: Formalin-fixed and paraffin-embedded tissue samples from 53 canine STSs (perivascular wall tumor (PWT), canine fibrosarcoma (cFS), and STS not further specified (NOS)), 24 feline fibrosarcomas, and 39 human STSs (myxofibrosarcoma, undifferentiated pleomorphic sarcoma, dermatofibrosarcoma protuberans, and malignant peripheral nerve sheath tumor) as well as six canine and seven feline healthy controls and 10 inflamed tissue samples were immunohistochemically stained for their FAP expression. FAP labeling in tumor, peritumoral, healthy skin, and inflamed tissue samples was quantified using a visually assessed semiquantitative expression score and digital image analysis. Target selection criteria (TASC) scoring was subsequently performed as previously described.Results: Eighty-five percent (85%) of human (33/39), 76% of canine (40/53), and 92% of feline (22/24) STSs showed FAP positivity in over 10% of the tumor cells. A high expression was determined in 53% canine (28/53), 67% feline (16/24), and 44% human STSs (17/39). The average FAP-labeled area of canine, feline, and human STSs was 31%, 33%, and 42%, respectively (p > 0.8990). The FAP-positive tumor area was larger in STS compared to healthy and peritumoral tissue samples (p < 0.0001). TASC scores were above 18 for all feline and human STS subtypes and canine PWTs but not for canine STS NOS and cFS.Conclusion: This study represents the first cross-species target evaluation of FAP for STS. Our results demonstrate that FAP expression is increased in various STS subtypes compared to non-cancerous tissues across species, thereby validating dogs and cats as suitable animal models. Based on a TASC score, FAP could be considered a target for FGS.

Purpose: Complete resection is a key prognostic factor for survival in patients with soft tissue sarcoma (STS), in humas and companion animals alike. Fluorescence-guided surgery could improve resection accuracy. As dogs are frequently affected by STS, they serve as a model to test an anti-α_vβ₃ integrin targeting near-infrared fluorescent (NIRF) dye (Angiostamp^TM800) for fluorescence-guided surgery in STS to evaluate its safety and feasibility in dogs, and if it translates into a clinically relevant benefit compared to the standard of care with regards to completeness of surgery and local recurrence. Furthermore, we aimed to correlate target expression and NIRF-signal intensity. Methods: Twenty dogs with STS were randomly allocated to either receive Angiostamp™ (NIRF group) or physiologic saline (control group) preoperatively. The researchers were blinded for treatment, and resections were adapted based on the NIRF-signal, if needed. Margin status was histologically determined at the 1 and 3 cm margin. The tumor-to-background ratio was measured in native tissue biopsies and formalin-fixed tissue. The fluorescent area was compared to the corresponding tumor areas as confirmed by histology using the Dice coefficient. Target expression was quantified by immunohistochemistry and correlated to NIRF-signal ratios. Results: A fluorescent signal was detected in all 10 tumors of the NIRF group, with a tumor-to-background ratio of 7.4 ± 5.8 in native biopsies and 13.5 ± 10.9 in formalin-fixed tissue. In the NIRF group, resection margins were adapted in 5/10 cases, leading to complete resection and preventing R1 in four of these cases. In the NIRF and control group 9/10 and 8/10 resections were R0, with one local recurrence in each group and one sarcoma-related death in the NIRF group. The NIRF-signal correlated with the histologically confirmed tumor area (Dice coefficient 0.75 ± 0.17). Target expression was higher in tumor compared to peritumoral tissue (p < 0.0003) and showed a moderate correlation with the NIRF-signal (r = 0.6516, p < 0.0001). Conclusion: Fluorescence-guided surgery using Angiostamp™ can pinpoint residual disease in the tumor bed and contributes to an improved resection accuracy in canine STS.