Quantification of surgical margin length changes after excision of feline injection site sarcomas-A pilot study

Vet Surg. 2017 Feb;46(2):189-196. doi: 10.1111/vsu.12602. Epub 2016 Dec 19.

Abstract

Objective: To evaluate degree length change of lateral surgical margins at various stages of processing for histological examination and quantify the length change between grossly normal surgical margins (GNSM) and pathologist-reported histologic tumor-free margin (HTFM) in widely resected feline injection site sarcoma (FISS) specimens.

Study design: Prospective clinical study.

Animals: Five client-owned cats with injection site sarcomas.

Methods: All cats underwent wide surgical excision (35-55 mm gross lateral margins, 2 fascial planes deep). Gross normal lateral margin measurements from tumor edge were recorded in 4 directions (cranial, caudal, dorsal, ventral) at 5 time points: intra-op (in vivo GNSM); immediately following excision (ex vivo GNSM); following formalin fixation (post-fixation GNSM); after trimming and mounting on glass slides (on-slide GNSM); and HTFM at the narrowest point from the HTFM from the same slides used for on-slide GNSM. Percent change in lateral margin length from in vivo measurements was quantified at each time point and compared using 1-way repeated measures ANOVA.

Results: The largest mean decrease in percent GNSM length occurred immediately after excision (in vivo to ex vivo GNSM = 29%; P = .016). Formalin fixation, trimming, and mounting on slides did not result in additional significant changes in length. Mean HTFM length was significantly decreased compared to both in vivo GNSM (33%; P = .014) and on-slide GNSM (7%; P = .024).

Conclusion: Significant decreases in surgical margin length in FISS specimens occur immediately following excision (prior to formalin fixation). Subgross evaluation of tumor-free margins from on-slide GNSM to HTFM overestimates the actual (histologic) tumor-free margins.

MeSH terms

  • Animals
  • Cat Diseases / pathology
  • Cat Diseases / surgery*
  • Cats
  • Female
  • Male
  • Margins of Excision*
  • Pilot Projects
  • Prospective Studies
  • Sarcoma / surgery
  • Sarcoma / veterinary*
  • Skin Neoplasms / surgery
  • Skin Neoplasms / veterinary*
  • Tissue Fixation*