Incomplete histological margins following planned narrow excision of canine appendicular soft tissue sarcomas and mast cell tumors, using the residual tumor classification scheme

Vet Surg. 2022 Oct;51(7):1078-1086. doi: 10.1111/vsu.13852. Epub 2022 Jul 13.

Abstract

Objective: To describe the frequency of incomplete histological margins following planned narrow excision (PNE) of mast cell tumors (MCTs) and soft tissue sarcomas (STSs), and to assess the residual tumor classification (R) scheme for reporting histological margins in clinical cases.

Study design: Retrospective clinical study.

Sample population: Forty-four client-owned dogs with 47 masses.

Methods: Medical records of dogs undergoing planned narrow excision of STSs and MCTs were reviewed (2016-2019). Histologic specimens were reviewed by a single pathologist and assigned R scoring (histologically incomplete/R1 margins defined as "tumor on ink").

Results: Six out of 23 (26%) MCT PNEs and 10/42 (42%) of STS PNEs resulted in R1 margins. R1 margins were more likely when performing PNE with 6-10 mm lateral measured surgical margins (LMSMs) versus 0-5 mm LMSM for MCTs (1/14 vs 5/9), but not STSs (3/7 vs 7/17) (P = .049). The R scheme resulted in higher retrospective percentage agreement in histological reporting than defining incomplete histological margin as tumor cells within ≤1 mm of the margin (83% vs 68% agreement). Complications occurred in 12/47 surgeries, with none requiring additional surgery. Tumors recurred in 3/18 (17%) STSs and 2/18 (11%) MCTs.

Conclusion: Fewer R1 margins were obtained when PNE with LMSM of 6-10 mm was performed for mast cell tumors. The use of the R scheme increased agreement in histopathological margin assessment.

Clinical significance: Planned narrow excision is a viable technique for histopathological diagnosis of appendicular soft tissue sarcomas and mast cell tumors for limb salvage.

MeSH terms

  • Animals
  • Dog Diseases* / pathology
  • Dog Diseases* / surgery
  • Dogs
  • Margins of Excision
  • Mast Cells / pathology
  • Neoplasm Recurrence, Local / veterinary
  • Neoplasm, Residual / veterinary
  • Retrospective Studies
  • Sarcoma* / surgery
  • Sarcoma* / veterinary
  • Seizures / veterinary
  • Skin Neoplasms* / surgery
  • Skin Neoplasms* / veterinary
  • Soft Tissue Neoplasms* / surgery
  • Soft Tissue Neoplasms* / veterinary