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Published on: June 26, 2016
Retraction of cutaneous specimens: tumours and margins after surgical excision
Marine Sevray1, Emilie Brenaut2,3, Yann Grangier4
1Dermatologie, CHU Brest, Brest, France marine.sevray@hotmail.fr.
Aims:
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.
Methods:
Patients who underwent excision of a skin tumour between January 2013 and July 2014 were randomly included.
Results:
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.
Conclusions:
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.
Insights
Skin tumor excision specimens retract significantly more than the tumor itself. This study quantizes specimen, tumor, and margin retraction, aiding in surgical margin assessment for skin cancer.
Area of Science:
- Dermatology
- Surgical Pathology
- Oncology
Background:
- Skin specimen retraction after surgical excision impacts margin assessment.
- Previous studies estimated surface, length, and width retraction percentages for skin specimens.
Purpose of the Study:
- To analyze the retraction of skin tumor specimens and their margins post-excision.
- To compare specimen area retraction with tumor retraction.
- To identify predictors of specimen area retraction.
Main Methods:
- Retrospective analysis of 104 patients undergoing skin tumor excision between January 2013 and July 2014.
- Measurement of specimen area, tumor, and margin retraction in length, width, and surface.
- Multivariate analysis to identify predictors of retraction.
Main Results:
- Specimen area retraction (29%) was significantly greater than tumor retraction (21%).
- Localisation and fixation duration predicted specimen area retraction.
- Specimen length and width retraction were 17% and 15%, respectively.
- Margin retraction was 19% in length and 12% in width.
- Surgeons correctly identified the smallest margin in 55% of cases.
Conclusions:
- This study provides crucial data on skin tumor and margin retraction.
- Understanding retraction is vital for interpreting histological margin sufficiency in skin cancer surgery.
- Findings can inform surgical guidelines for achieving adequate margins.
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