Nerve-sparing prostatectomy shows promise in dogs with early tumors

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A newly published retrospective case series suggests that nerve-sparing total prostatectomy may be more feasible in carefully selected dogs with early-stage prostatic tumors than many clinicians have assumed. In 22 dogs with T1 to T3 prostatic tumors or preneoplastic lesions, the procedure was associated with a low rate of surgical complications, 68.2% long-term full urinary continence, and improved survival, with or without adjuvant chemotherapy, according to the study by Salmina, Chiti, Cinti, and Massari. The report adds to a small but growing body of literature indicating that earlier surgical intervention, before extensive local invasion, may improve outcomes in canine prostatic cancer. (pubmed.ncbi.nlm.nih.gov)

Why it matters: For veterinary professionals, the finding is notable because total prostatectomy in dogs has long been approached cautiously due to historically high rates of postoperative incontinence and the aggressive biology of prostatic carcinoma. Reference sources still note that total prostatectomy is generally not recommended because many dogs already have metastasis at diagnosis and continence outcomes have been poor. This new series suggests that a nerve-sparing approach, used in earlier-stage disease, could shift that discussion for selected referral cases, especially where staging shows T1 to T3 disease without the degree of invasion typically associated with worse outcomes. (merckvetmanual.com)

What to watch: The next question is whether larger, prospective studies can confirm which dogs benefit most, and whether nerve-sparing surgery plus adjuvant therapy can reliably outperform medical management across institutions. (bmcvetres.biomedcentral.com)