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News Article

Study explores surgical margins for feline injection site sarcomas

A prospective clinical pilot study quantified changes in lateral surgical margin length at specific processing steps, from intraoperatively to final histopathological evaluation.

Researchers at Oregon State University (OSU) are paving the way for more precision in determining surgical margins for feline injection site sarcoma (FISS) by analysing tissue contraction at various stages of the post-operative examination process.

The findings, published in Veterinary Surgery, are important because inaccuracy in FISS surgical margins can have a negative effect on the patient’s health, whether the margin is bigger or smaller than necessary.

Understanding how margin length decreases from surgery to pathology - because of how the removed tissue shrinks and tumour cells invade surrounding tissues - can lead to better surgical margin planning and in turn a better prognosis, said corresponding author Milan Milovancev at OSU’s College of Veterinary Medicine.

“If we can understand the relationship between what the pathologist sees on a slide under a microscope and what the surgeon is taking out in the operating room, and what accounts for the differences between the two, then we can work backward and figure out how much surgical margin to take,” he said.

The pilot study looked at 35- to 55-millimetre surgical margins from five cats with FISS and found the greatest margin decreases occurred right after excision. It also found the margins tended to be larger than necessary.

“Older studies showed that if you had bigger margins, cats would live longer,” Milovancev said. “The previous margin guidelines of 2 to 3 centimetres had been found to be inadequate, and the new guidelines were 5, which seemed like a big jump and in some of these cats may cause a lot of unnecessary suffering.

“The net take-home is that yes, 2 to 3 centimetres is indeed inadequate, but we didn’t find any tumours getting close to 5 centimetres. We can reduce morbidity by surgically removing what we need to take out and leaving what doesn’t need to be taken out.”

Milovancev notes that future, larger studies that categorize results by factors that might influence tumour-free margin length - such as tumour grade and location - are likely to lead to more refined preoperative surgical planning.

Article: Quantification of surgical margin length changes after excision of feline injection site sarcomas - A pilot study by Jesse L. Terry, Milan Milovancev, Sarah Nemanic and Christiane V. Löhr, published in Veterinary Surgery (2017) vol. 46, no. 2, pp. 189-196, doi: 10.1111/vsu.12602

Article details

  • Date
  • 14 June 2017
  • Source
  • Oregon State University
  • Subject(s)
  • Dogs, Cats, and other Companion Animals