Comparison of histologic margin status in low-grade cutaneous and subcutaneous canine mast cell tumours examined by radial and tangential sections

Vet Comp Oncol. 2018 Mar;16(1):125-130. doi: 10.1111/vco.12321. Epub 2017 May 23.

Abstract

Background: Radial sections are widely used to estimate adequacy of excision in canine cutaneous mast cell tumours (MCTs); however, this sectioning technique estimates only a small fraction of total margin circumference. This study aimed to compare histologic margin status in grade II/low grade MCTs sectioned using both radial and tangential sectioning techniques.

Materials and methods: A total of 43 circumferential margins were evaluated from 21 different tumours. Margins were first sectioned radially, followed by tangential sections. Tissues were examined by routine histopathology.

Results: Tangential margin status differed in 10 of 43 (23.3%) margins compared with their initial status on radial section. Of 39 margins, 9 (23.1%) categorized as histologic tumour-free margin (HTFM) >0 mm were positive on tangential sectioning. Tangential sections detected a significantly higher proportion of positive margins relative to radial sections (exact 2-tailed P-value = .0215). The HTFM was significantly longer in negative tangential margins than positive tangential margins (mean 10.1 vs 3.2 mm; P = .0008). A receiver operating characteristic curve comparing HTFM and tangentially negative margins found an area under the curve of 0.83 (95% confidence interval: 0.71-0.96). Although correct classification peaked at the sixth cut-point of HTFM ≥1 mm, radial sections still incorrectly classified 50% of margins as lacking tumour cells. Radial sections had 100% specificity for predicting negative tangential margins at a cut-point of 10.9 mm.

Conclusion: These data indicate that for low grade MCTs, HTFMs >0 mm should not be considered completely excised, particularly when HTFM is <10.9 mm. This will inform future studies that use HTFM and overall excisional status as dependent variables in multivariable prognostic models.

Keywords: HTFM; ROC; excision; histopathology; sensitivity; specificity.

Publication types

  • Comparative Study

MeSH terms

  • Animals
  • Biopsy / methods
  • Biopsy / veterinary
  • Dog Diseases / pathology*
  • Dog Diseases / surgery
  • Dogs
  • Female
  • Male
  • Margins of Excision
  • Mastocytosis, Cutaneous / pathology
  • Mastocytosis, Cutaneous / surgery
  • Mastocytosis, Cutaneous / veterinary*
  • Sensitivity and Specificity
  • Skin / pathology
  • Treatment Outcome