Risk factors for survival after adrenal gland tumor surgery in dogs

Abstract

OBJECTIVE: To evaluate risk factors for outcome for dogs with adrenal gland tumors with or without invasion of the caudal vena cava treated via adrenalectomy. DESIGN: Retrospective study. ANIMALS: 86 dogs that underwent adrenalectomy for treatment of adrenal gland tumors. PROCEDURES: Medical records of dogs that underwent adrenalectomy for treatment of an adrenal gland tumor from 1993 to 2009 were reviewed; data collected including signalment, clinical signs, diagnostic test findings, treatments prior to surgery, findings at surgery including additional procedures performed and extent of caudal vena caval invasion (local invasion [caudal to the hepatic portion of the vena cava] or extensive invasion [cranial to the hepatic portion of the vena cava]), procedures performed during surgery, histopathologic diagnosis, perioperative complications, follow-up data, and necropsy findings. RESULTS: Of the 86 dogs, 14 had adenomas, 45 had adrenocortical carcinomas, and 27 had pheochromocytomas. Fourteen dogs had invasion of the caudal vena cava; of these tumors, 7 were locally invasive and 7 were extensively invasive. Risk factors for poor short-term survival (death within 14 days following surgery) were vena caval invasion, extent of invasion, pheochromocytoma, intraoperative transfusion, and postoperative factors including disseminated intravascular coagulation, pancreatitis, hypotension, hypoxemia, and renal failure. Multivariate analysis of risk factors for poor short-term survival revealed that extensive invasion was the most important factor. Regardless of extent of invasion or tumor type, long-term survival was possible. CONCLUSIONS AND CLINICAL RELEVANCE: Invasion of the caudal vena cava, particularly tumor thrombus extension beyond the hepatic hilus, was associated with a higher postoperative mortality rate, but did not affect long-term prognosis in dogs undergoing adrenalectomy because of an adrenal gland tumor.