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Invasive vulvar carcinoma and the question of the surgical margin
Author(s) -
Palaia Innocenza,
Bellati Filippo,
Calcagno Marco,
Musella Angela,
Perniola Giorgia,
Panici Pierluigi B.
Publication year - 2011
Publication title -
international journal of gynecology and obstetrics
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.895
H-Index - 97
eISSN - 1879-3479
pISSN - 0020-7292
DOI - 10.1016/j.ijgo.2011.02.012
Subject(s) - margin (machine learning) , medicine , vulvar carcinoma , surgical margin , resection margin , carcinoma in situ , carcinoma , surgery , radiology , pathology , resection , machine learning , computer science
Objective To assess the discrepancy between width of surgical margin measured with the naked eye/ruler by a surgeon before removing an invasive vulvar carcinoma, and width of margin measured under microscope by pathologist after fixation of the resected lesion with formalin. Potential relationships between discrepancy and disease recurrence were also investigated. Methods This prospective study was conducted with resected lesions from 86 women who underwent surgery for primary/recurrent invasive vulvar carcinoma. After the surgeon removed the lesions surrounded by 1–2‐cm margins, the pathologist determined margin width at the 4 cardinal points of 86 lesions (for a total of 344 margin assessments), first macroscopically and then under the microscope. Results A safety margin of 0.8 cm on microscopic view was achieved in 83% of cases (112 of 135) when the macroscopic measurement was 1 cm, in 91% of cases (58 of 64) when it was 1.5 cm, and 98% of cases (105 of 107) when it was 2 cm. Conclusion There was a small discrepancy between the surgeon's intent and the microscopic margin measurement, mostly related to tissue shrinkage. A 1‐cm surgical margin corresponded to a 0.8‐cm margin in microscopic view (the “safe margin”) in most cases.