Retraction of cutaneous specimens: tumours and margins after surgical excision
Tóm tắt
In previous studies, skin retraction of dermato-pathological specimens after the surgical excision of tumours was calculated at 30% for the surface, with approximately 20% for the length and 15% for the width. The aim of this study was to analyse the retraction of the specimens and the retraction of the lesion and the margins.
Patients who underwent excision of a skin tumour between January 2013 and July 2014 were randomly included.
A total of 104 patients was included. There were 52% male with a mean age of 68.3 years. Seventy-eight per cent of the lesions were malignant (51% were basal cell carcinoma, 10% squamous cell carcinoma). The retraction of the area of the specimen (29%) was significantly greater than the retraction of the tumour (21%). On multivariate analysis, the localisation and the duration of fixation were independent predictors of the specimen area retraction. The retraction of the specimen was 17% in length and 15% in width. The retraction of the margins was calculated at 19% in length and 12% in width. The surgeon correctly evaluated the localisation of the smallest margin in 55% of cases.
Our study provided additional data regarding the retraction of the tumours and margins. The guidelines for surgical excision of skin cancers recommend a clinical margin before excision, but the evaluation of the sufficiency of the margins is based on histological measurement. Our data are useful for the interpretation of the sufficiency of the margins.
Từ khóa
Tài liệu tham khảo
Dumas, 2012, [Study of skin retraction applied to the treatment of skin tumors. Mapping of the human body], Ann Chir Plast Esthet, 57, 118, 10.1016/j.anplas.2012.02.004
Dauendorffer, 2009, Shrinkage of skin excision specimens: formalin fixation is not the culprit, Br J Dermatol, 160, 810, 10.1111/j.1365-2133.2008.08994.x
Blasco-Morente, 2015, Study of shrinkage of cutaneous surgical specimens, J Cutan Pathol, 42, 253, 10.1111/cup.12401
Blasdale, 2010, Effect of tissue shrinkage on histological tumour-free margin after excision of basal cell carcinoma, Br J Dermatol, 162, 607, 10.1111/j.1365-2133.2009.09577.x
Nahhas, 2017, A review of the global guidelines on surgical margins for nonmelanoma skin cancers, J Clin Aesthet Dermatol, 10, 37
Ethun, 2016, The importance of surgical margins in melanoma, J Surg Oncol, 113, 339, 10.1002/jso.24111
Edwards, 2017, Diagnostic accuracy of reflectance confocal microscopy using VivaScope for detecting and monitoring skin lesions: a systematic review, Clin Exp Dermatol, 42, 266, 10.1111/ced.13055
Hayashi, 2014, Detection of the tumor margin of basal-cell carcinoma using dermoscopy and high-frequency ultrasound with narrow pieces of surgical tape as skin markers, Dermatol Surg, 40, 704