Brønden et al. Acta Veterinaria Scandinavica 2010, 52:6 http://www.actavetscand.com/content/52/1/6 Grade II MCT were most often as recommended sur- gically excised. It was however noted that surgery was less often performed for both grade I and III tumours. Grade III tumours have a very poor prognosis even with treatment, which might discourage owners from exten- sive surgery. This may explain the discrepancy in sur- gery performed in MCT cases of different grades. The location of MCT as a prognostic factor has been discussed in the literature and neoplasms in the muco- cutaneous junctions and inguinal region have been reported as more aggressive and connected to a higher risk of metastasis than MCT in other locations [9]. However, no single prognostic factor has proven super- ior in the prediction of MCT prognosis [12]. Surgery was performed equally often on MCT located on the trunk and on extremities even though the latter location often impairs the use of wide surgery margins. Despite signs of metastases, indicating stage III or IV of the dis- ease, 10 out of 15 cases had surgery performed. Surgery may be used as a palliative measure in the treatment of MCT as metastases can cause significant discomfort in the patient. The treatment of choice in grade I and grade II MCT is surgery as recommended by Dobson and Scase [9] among others. Surgery should be performed with 2 cm margins [6,8]. In the current study surgery was per- formed in 73% of the MCT cases in the DVCR suggest- ing that cases of MCT are treated according to the recommendations at the participating veterinary clinics. Treatment recommendation for high grade MCT includes both surgery and adjunctive therapy in the form of radiation or chemotherapy. This is consistent with the fact that half of the grade III cases had corti- costeroid treatment. Apart from corticosteroid treatment and 1 case of chemotherapy, adjunctive therapy was not pursued in the MCT treatments reported to the DVCR. This is expected as both therapies are relatively new modalities in canine cancer treatment in Denmark com- pared to other countries [13,14]. Other prognostic factors for MCT have been investi- gated e.g. Ki67 index, c-KIT mutations, mitotic index, and surgical margins. These parameters were not included in the DVCR records as they are not routinely considered in primary practice diagnostic work-up. The DVCR may be used to locate cases for case-control stu- dies or for follow-up studies of cases treated following certain protocols. The DVCR offers an insight into the actual situation from primary practice clinics and hospitals among Dan- ish dogs encountering skin neoplasms. Using MCT as an example, an attempt was made to outline the diag- nostic modalities used and the treatments chosen when dogs are diagnosed (with MCT) outside a clinical trial setting. This knowledge can help uncover the Page 5 of 6 consequences of non-consensus treatment, which is gen- erally based on historical or empiric data. The choice of treatment is based upon the owners’ choice and depends on many factors such as financial, ethical, social and animal welfare considerations. The latter, including sur- vival time estimates, is an important part of the owner decision making and while clinical trials and controlled studies can contribute with information of the likely consequences of specific treatment regiments the DVCR might over time be able to uncover the consequences of the alternatives. Conclusions The occurrence, gender distribution, histological malig- nancy and location of skin neoplasias in Denmark were in agreement with the majority of earlier reports, although some unexplained national variations seem to occur. The most commonly occurring malignant cuta- neous neoplasms were MCT and STS. Population based cancer registries like the DVCR are of importance in order to collect non-selected primary information of occurrence and distribution of neolasms. The DVCR provides detailed information on cases of skin neoplasms in dogs and may serve as a platform for the study of sub-sets of neoplastic diseases (e.g. MCT) or subgroups of the canine population (e.g. a specific breed). Acknowledgements The authors would like to thank the veterinarians at the clinics and hospitals who have participated and submitted cases of neoplasia to the DVCR. Authors’ contributions LBB carried out data management and statistical analysis, participated in designing the study, evaluating results, researching background literature and drafting the manuscript. TE participated in designing the study, evaluating results, researching background literature and drafting the manuscript. ATK participated in the coordination and drafting of the manuscript. All authors read and approved the final manuscript. Competing interests The authors declare that they have no competing interests. Received: 8 June 2009 Accepted: 22 January 2010 Published: 22 January 2010 References 1. Arnesen K, Gamlem H, Glattre E, Grøndalen J, Moe L, Nordstoga K: The Norwegian Canine Cancer Register 1990-1998. Report from the project “Cancer in the Dog”. EJCAP 2001, XI:159-169. 2. Dobson JM, Samuel S, Milstein H, Rogers K, Wood JL: Canine neoplasia in the UK: estimates of incidence rates from a population of insured dogs. J Small Anim Pract 2002, 43:240-246. 3. Dorn CR, Taylor DO, Schneider R, Hibbard HH, Klauber MR: Survey of animal neoplasms in Alameda and Contra Costa Counties, California. II. Cancer morbidity in dogs and cats from Alameda County. J Natl Cancer Inst 1968, 40:307-318. 4. MacVean DW, Monlux AW, Anderson PS Jr, Silberg SL, Roszel JF: Frequency of canine and feline tumors in a defined population. Vet Pathol 1978, 15:700-715.