Canine oral fibrosarcoma: Changes in prognosis over the last 30 years?

Canine oral fibrosarcoma (oFSA) is a malignant, infiltrating, mesenchymal tumour affecting the oral cavity primarily of medium to large middle aged dogs. The diagnosis often is made late in the course of the disease, due to the frequent caudal location of the tumour, and histopathology is not always sufficient to discriminate undifferentiated oFSA from other poorly differentiated malignant mesenchymal tumours occurring at the same site, especially in small biopsy samples. The literature exclusively relating to oFSA is limited and outcome data following treatment are difficult to compare. The purpose of this article is to provide an overview of the literature spanning the last 30 years, specifically with regard to different treatment modalities in their relation to prognosis of canine oFSA. Overall, the survival rate for dogs with oFSA has improved in recent years (overall survival 247-743 days, compared to 30-540 days in papers published before 2000), probably due to better surgical planning. The major concern in clinical management of canine oFSA is the high local rate of recurrence (up to 57%), whereas metastasis occurs late in about 10-14% of affected dogs. Wide surgical excision is the mainstay of treatment. Initially, the tumour was considered to be radioresistant, but a combination of surgery and radiotherapy seems to be the most promising treatment modality at present. Despite a histopathological diagnosis of a low-grade tumour, an aggressive treatment approach is always warranted to cure oFSA, but the ability to control local disease still represents the major challenge.