Practical Guidance for Measuring and Reporting Surgical Margins in Vulvar Cancer

Area of Science:

• Gynecologic Pathology
• Surgical Oncology
• Cancer Research

Background:

• Surgical resection with free margins is crucial for treating vulvar squamous cell carcinoma (VSCC).
• Reexcision is typically recommended when the minimum peripheral surgical margin (MPSM) is less than 8mm.
• Current guidelines lack standardized methods for measuring MPSM in VSCC specimens.

Purpose of the Study:

• To establish a consensus-based definition for measuring MPSM in VSCC resections.
• To address the lack of uniformity in reporting surgical margin status for VSCC.
• To provide clear guidance for pathologists on MPSM measurement.

Main Methods:

• An online survey was conducted among pathologists regarding MPSM measurement in VSCC.
• The survey included questions and diagrams illustrating peripheral margin measurements.
• 57 pathologists participated in the survey to reach a consensus.

Main Results:

• A consensus-based definition for MPSM in VSCC was proposed.
• MPSM is defined as the minimum distance from invasive tumor nests to the inked peripheral margin, measured in millimeters through tissue.
• Recommendations include measuring MPSM in a straight line and reporting other relevant measurements like depth of invasion.

Conclusions:

• The proposed definition promotes uniformity in measuring and reporting MPSM in VSCC resection specimens.
• Standardized MPSM measurement is essential for guiding treatment decisions and improving patient outcomes in VSCC.
• This guidance aims to enhance consistency in pathology reports for VSCC.