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Practical Guidance for Measuring and Reporting Surgical Margins in Vulvar Cancer

Surgical resection with free surgical margins is the cornerstone of successful primary treatment of vulvar squamous cell carcinoma (VSCC). In general reexcision is recommended when the minimum peripheral surgical margin (MPSM) is <8 mm microscopically. Pathologists are, therefore, required to rep...

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Autores principales: Kortekaas, Kim E., Van de Vijver, Koen K., van Poelgeest, Mariëtte I.E., Gilks, C. Blake, Smit, Vincent T.H.B.M., Arif, Saimah, Arora, Deep, Faruqi, Asma, Ganesan, Raji, Griffin, Nicholas R., Hale, Richard, Hock, Yelin E., Horn, Lars-Christian, McCluggage, W. Glenn, Mukonoweshuro, Pinias, Park, Kay J., Rous, Brian, Tanchel, Bruce, Van Rompuy, Anne-Sophie, van Schalkwyk, Gerry, Vella, Jo, Vergine, Marco, Singh, Naveena, Bosse, Tjalling
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Lippincott Williams & Wilkins 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478209/
https://www.ncbi.nlm.nih.gov/pubmed/31460873
http://dx.doi.org/10.1097/PGP.0000000000000631
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author Kortekaas, Kim E.
Van de Vijver, Koen K.
van Poelgeest, Mariëtte I.E.
Gilks, C. Blake
Smit, Vincent T.H.B.M.
Arif, Saimah
Arora, Deep
Faruqi, Asma
Ganesan, Raji
Griffin, Nicholas R.
Hale, Richard
Hock, Yelin E.
Horn, Lars-Christian
McCluggage, W. Glenn
Mukonoweshuro, Pinias
Park, Kay J.
Rous, Brian
Tanchel, Bruce
Van Rompuy, Anne-Sophie
van Schalkwyk, Gerry
Vella, Jo
Vergine, Marco
Singh, Naveena
Bosse, Tjalling
author_facet Kortekaas, Kim E.
Van de Vijver, Koen K.
van Poelgeest, Mariëtte I.E.
Gilks, C. Blake
Smit, Vincent T.H.B.M.
Arif, Saimah
Arora, Deep
Faruqi, Asma
Ganesan, Raji
Griffin, Nicholas R.
Hale, Richard
Hock, Yelin E.
Horn, Lars-Christian
McCluggage, W. Glenn
Mukonoweshuro, Pinias
Park, Kay J.
Rous, Brian
Tanchel, Bruce
Van Rompuy, Anne-Sophie
van Schalkwyk, Gerry
Vella, Jo
Vergine, Marco
Singh, Naveena
Bosse, Tjalling
author_sort Kortekaas, Kim E.
collection PubMed
description Surgical resection with free surgical margins is the cornerstone of successful primary treatment of vulvar squamous cell carcinoma (VSCC). In general reexcision is recommended when the minimum peripheral surgical margin (MPSM) is <8 mm microscopically. Pathologists are, therefore, required to report the minimum distance from the tumor to the surgical margin. Currently, there are no guidelines on how to make this measurement, as this is often considered straightforward. However, during the 2018 Annual Meeting of the British Association of Gynaecological Pathologists (BAGP), a discussion on this topic revealed a variety of opinions with regard to reporting and method of measuring margin clearance in VSCC specimens. Given the need for uniformity and the lack of guidance in the literature, we initiated an online survey in order to deliver a consensus-based definition of peripheral surgical margins in VSCC resections. The survey included questions and representative diagrams of peripheral margin measurements. In total, 57 pathologists participated in this survey. On the basis of consensus results, we propose to define MPSM in VSCC as the minimum distance from the peripheral edge of the invasive tumor nests toward the inked peripheral surgical margin reported in millimeters. This MPSM measurement should run through tissue and preferably be measured in a straight line. Along with MPSM, other relevant measurements such as depth of invasion or tumor thickness and distance to deep margins should be reported. This manuscript provides guidance to the practicing pathologist in measuring MPSM in VSCC resection specimens, in order to promote uniformity in measuring and reporting.
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spelling pubmed-74782092020-09-24 Practical Guidance for Measuring and Reporting Surgical Margins in Vulvar Cancer Kortekaas, Kim E. Van de Vijver, Koen K. van Poelgeest, Mariëtte I.E. Gilks, C. Blake Smit, Vincent T.H.B.M. Arif, Saimah Arora, Deep Faruqi, Asma Ganesan, Raji Griffin, Nicholas R. Hale, Richard Hock, Yelin E. Horn, Lars-Christian McCluggage, W. Glenn Mukonoweshuro, Pinias Park, Kay J. Rous, Brian Tanchel, Bruce Van Rompuy, Anne-Sophie van Schalkwyk, Gerry Vella, Jo Vergine, Marco Singh, Naveena Bosse, Tjalling Int J Gynecol Pathol Pathology of the Lower Tract: Original Articles Surgical resection with free surgical margins is the cornerstone of successful primary treatment of vulvar squamous cell carcinoma (VSCC). In general reexcision is recommended when the minimum peripheral surgical margin (MPSM) is <8 mm microscopically. Pathologists are, therefore, required to report the minimum distance from the tumor to the surgical margin. Currently, there are no guidelines on how to make this measurement, as this is often considered straightforward. However, during the 2018 Annual Meeting of the British Association of Gynaecological Pathologists (BAGP), a discussion on this topic revealed a variety of opinions with regard to reporting and method of measuring margin clearance in VSCC specimens. Given the need for uniformity and the lack of guidance in the literature, we initiated an online survey in order to deliver a consensus-based definition of peripheral surgical margins in VSCC resections. The survey included questions and representative diagrams of peripheral margin measurements. In total, 57 pathologists participated in this survey. On the basis of consensus results, we propose to define MPSM in VSCC as the minimum distance from the peripheral edge of the invasive tumor nests toward the inked peripheral surgical margin reported in millimeters. This MPSM measurement should run through tissue and preferably be measured in a straight line. Along with MPSM, other relevant measurements such as depth of invasion or tumor thickness and distance to deep margins should be reported. This manuscript provides guidance to the practicing pathologist in measuring MPSM in VSCC resection specimens, in order to promote uniformity in measuring and reporting. Lippincott Williams & Wilkins 2020-09 2019-08-26 /pmc/articles/PMC7478209/ /pubmed/31460873 http://dx.doi.org/10.1097/PGP.0000000000000631 Text en Copyright © 2019 The Author(s). Published by Wolters Kluwer Health, Inc. on behalf of the International Society of Gynecological Pathologists This is an open-access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (http://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/
spellingShingle Pathology of the Lower Tract: Original Articles
Kortekaas, Kim E.
Van de Vijver, Koen K.
van Poelgeest, Mariëtte I.E.
Gilks, C. Blake
Smit, Vincent T.H.B.M.
Arif, Saimah
Arora, Deep
Faruqi, Asma
Ganesan, Raji
Griffin, Nicholas R.
Hale, Richard
Hock, Yelin E.
Horn, Lars-Christian
McCluggage, W. Glenn
Mukonoweshuro, Pinias
Park, Kay J.
Rous, Brian
Tanchel, Bruce
Van Rompuy, Anne-Sophie
van Schalkwyk, Gerry
Vella, Jo
Vergine, Marco
Singh, Naveena
Bosse, Tjalling
Practical Guidance for Measuring and Reporting Surgical Margins in Vulvar Cancer
title Practical Guidance for Measuring and Reporting Surgical Margins in Vulvar Cancer
title_full Practical Guidance for Measuring and Reporting Surgical Margins in Vulvar Cancer
title_fullStr Practical Guidance for Measuring and Reporting Surgical Margins in Vulvar Cancer
title_full_unstemmed Practical Guidance for Measuring and Reporting Surgical Margins in Vulvar Cancer
title_short Practical Guidance for Measuring and Reporting Surgical Margins in Vulvar Cancer
title_sort practical guidance for measuring and reporting surgical margins in vulvar cancer
topic Pathology of the Lower Tract: Original Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7478209/
https://www.ncbi.nlm.nih.gov/pubmed/31460873
http://dx.doi.org/10.1097/PGP.0000000000000631
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