Soft tissue sarcoma in the dog - Part 2: surgical margins, controversies and a comparative review

Soft tissue sarcoma constitutes a heterogeneous group of mesenchymal tumours. Although they are common in the dog, many uncertainties surround the best options for clinical management. Despite recent improvements in outcome, approximately one in five patients may still die as a result of their disease. There is some evidence that wide surgical excision may not be required for every soft tissue sarcoma but, conversely, complacency in treatment may adversely affect outcomes for patients with aggressive disease. The purpose of this review is to examine the issues affecting the management of canine soft tissue sarcoma, and to evaluate the human literature for lessons that may guide future treatment directions for dogs. Comparative lessons from human soft tissue sarcoma that may be important for the canine patient in the future include (1) understanding the oncogenic potential of the pseudocapsule to better predict tumour behaviour and optimal surgical margins, (2) recognising the importance of planned multi-modality therapy for improving tumour control, (3) considering a role for compartmental resection strategies and (4) improving the accuracy of pretreatment analysis of the tumour to better predict behaviour and optimal treatment options.