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Surgical Margins for Ameloblastoma in Dogs: A Review With an Emphasis on the Future

Ameloblastoma is a benign epithelial odontogenic tumor with the capacity to aggressively invade the surrounding bone. Surgical removal of the tumor can result in extended disease-free interval (cure). However, controversy surrounds the most appropriate surgical margin required to prevent local recur...

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Autor principal: Goldschmidt, Stephanie
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980539/
https://www.ncbi.nlm.nih.gov/pubmed/35392113
http://dx.doi.org/10.3389/fvets.2022.830258
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author Goldschmidt, Stephanie
author_facet Goldschmidt, Stephanie
author_sort Goldschmidt, Stephanie
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description Ameloblastoma is a benign epithelial odontogenic tumor with the capacity to aggressively invade the surrounding bone. Surgical removal of the tumor can result in extended disease-free interval (cure). However, controversy surrounds the most appropriate surgical margin required to prevent local recurrence while simultaneously minimizing morbidity. En bloc excisional surgery carries the risk of major complications such as mandibular drift, hemorrhage, and oronasal fistula formation. Conservative therapy without a safety margin reduces potential morbidity but is likely to result in local recurrence. No reliable rate, nor time to recurrence, is documented but may be as high as 91% with conservative therapy. Conversely, surgery with a 10- to 20-mm margin is associated with a 0–4.6% recurrence rate. There is no documented difference in the recurrence rate with a 10- vs. 20-mm margin. The correlation of the histologic margin with the recurrence rate following excisional surgery has not determined a required histologic safety margin. Rather, no local recurrence occurs despite narrow or incomplete margins. Thus, pathologic margins > 0 mm may be sufficient to prevent local recurrence or recurrence may be protracted. Accordingly, a narrow (5–10 mm) gross surgical margin may be the most appropriate. Additional research is required for confirmation, and only level 4 evidence on safety margins has been achieved thus far. Future work should focus on defining the extension of neoplastic cells past the demarcation of ameloblastoma on variable diagnostic imaging modalities as well as determining the recurrence rate with various surgical and histologic safety margins.
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spelling pubmed-89805392022-04-06 Surgical Margins for Ameloblastoma in Dogs: A Review With an Emphasis on the Future Goldschmidt, Stephanie Front Vet Sci Veterinary Science Ameloblastoma is a benign epithelial odontogenic tumor with the capacity to aggressively invade the surrounding bone. Surgical removal of the tumor can result in extended disease-free interval (cure). However, controversy surrounds the most appropriate surgical margin required to prevent local recurrence while simultaneously minimizing morbidity. En bloc excisional surgery carries the risk of major complications such as mandibular drift, hemorrhage, and oronasal fistula formation. Conservative therapy without a safety margin reduces potential morbidity but is likely to result in local recurrence. No reliable rate, nor time to recurrence, is documented but may be as high as 91% with conservative therapy. Conversely, surgery with a 10- to 20-mm margin is associated with a 0–4.6% recurrence rate. There is no documented difference in the recurrence rate with a 10- vs. 20-mm margin. The correlation of the histologic margin with the recurrence rate following excisional surgery has not determined a required histologic safety margin. Rather, no local recurrence occurs despite narrow or incomplete margins. Thus, pathologic margins > 0 mm may be sufficient to prevent local recurrence or recurrence may be protracted. Accordingly, a narrow (5–10 mm) gross surgical margin may be the most appropriate. Additional research is required for confirmation, and only level 4 evidence on safety margins has been achieved thus far. Future work should focus on defining the extension of neoplastic cells past the demarcation of ameloblastoma on variable diagnostic imaging modalities as well as determining the recurrence rate with various surgical and histologic safety margins. Frontiers Media S.A. 2022-03-22 /pmc/articles/PMC8980539/ /pubmed/35392113 http://dx.doi.org/10.3389/fvets.2022.830258 Text en Copyright © 2022 Goldschmidt. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Veterinary Science
Goldschmidt, Stephanie
Surgical Margins for Ameloblastoma in Dogs: A Review With an Emphasis on the Future
title Surgical Margins for Ameloblastoma in Dogs: A Review With an Emphasis on the Future
title_full Surgical Margins for Ameloblastoma in Dogs: A Review With an Emphasis on the Future
title_fullStr Surgical Margins for Ameloblastoma in Dogs: A Review With an Emphasis on the Future
title_full_unstemmed Surgical Margins for Ameloblastoma in Dogs: A Review With an Emphasis on the Future
title_short Surgical Margins for Ameloblastoma in Dogs: A Review With an Emphasis on the Future
title_sort surgical margins for ameloblastoma in dogs: a review with an emphasis on the future
topic Veterinary Science
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8980539/
https://www.ncbi.nlm.nih.gov/pubmed/35392113
http://dx.doi.org/10.3389/fvets.2022.830258
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