title: Improved survival associated with postoperative wound infection in dogs treated with limb-salvage surgery for osteosarcoma.
abstract: BACKGROUND
  Limb-salvage surgery and adjuvant chemotherapy are performed as a treatment of appendicular osteosarcoma in dogs. Approximately 50% of dogs that undergo limb-salvage surgery develop postoperative surgical wound infections. Postoperative surgical infections may affect survival in cancer patients. The purposes of this study were to examine the effect of surgical wound infection on survival, local recurrence, and metastasis in relation to other prognostic factors for dogs with spontaneous osteosarcoma treated with limb-salvage surgery.
  
  
  METHODS
  Forty-seven client-owned dogs with osteosarcoma of the distal radius were treated with limb-salvage surgery and adjuvant chemotherapy--either carboplatin or carboplatin and doxorubicin. Hazard ratios were estimated by using the Cox proportional hazard model, and survival functions were estimated by using the Kaplan-Meier product-limit life-table method.
  
  
  RESULTS
  Of the 47 dogs in this study, 32 (68%) developed a postoperative wound infection. Infection, dog weight, and extent of the primary tumor (percentage of length) significantly affected survival, and infection and percentage of length significantly affected time to metastasis. None of the variables considered in this study affected local recurrence. Dogs that were diagnosed with an infection were less likely to die (hazard ratio, .446), and dogs with greater body weight and greater percentage length involvement were more likely to die (hazard ratios of 3.37 and 3.66, respectively).
  
  
  CONCLUSIONS
  In dogs with osteosarcoma treated with limb-salvage surgery, infection has a positive influence on survival, as does a smaller initial length of radius involved and lower body weight.
authors.affiliation: Department of Clinical Sciences, College of Veterinary Medicine, North Carolina State University, Raleigh, NC 27606, USA. duncan_lascelles@ncsu.edu
authors.forename: B Duncan X
authors.initials: BD
authors.lastname: Lascelles
authors.forename: William S
authors.initials: WS
authors.lastname: Dernell
authors.forename: Maria T
authors.initials: MT
authors.lastname: Correa
authors.forename: Mary
authors.initials: M
authors.lastname: Lafferty
authors.forename: Chad M
authors.initials: CM
authors.lastname: Devitt
authors.forename: Charles A
authors.initials: CA
authors.lastname: Kuntz
authors.forename: Rodney C
authors.initials: RC
authors.lastname: Straw
authors.forename: Stephen J
authors.initials: SJ
authors.lastname: Withrow
mesh_terms: D000818:Animals; D001859:Bone Neoplasms / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D017024:Chemotherapy, Adjuvant; D004285:Dogs; D005260:Female; D006614:Hindlimb; D023821:Limb Salvage; D008297:Male; D009364:Neoplasm Recurrence, Local; D012516:Osteosarcoma / Q000188:drug therapy / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology; D016016:Proportional Hazards Models; D011884:Radius; D013530:Surgical Wound Infection / Q000453:epidemiology*; D016019:Survival Analysis