Difference between revisions of "Surgical margins"

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Surgical margins (view source)

Revision as of 00:52, 28 August 2012

210 bytes added ,  00:52, 28 August 2012
→‎Adequate margins by tumour
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{| class="wikitable sortable"  
{| class="wikitable sortable"  
!Tumour  
!Tumour  
!Margin
!Pathologic margin
!Clinical margin
!System
!System
|-
|-
| [[Colorectal carcinoma]]  
| [[Colorectal carcinoma]]  
| prior to [[TME]] 1 cm -- less may be okay<ref>{{Cite journal  | last1 = Fitzgerald | first1 = TL. | last2 = Brinkley | first2 = J. | last3 = Zervos | first3 = EE. | title = Pushing the envelope beyond a centimeter in rectal cancer: oncologic implications of close, but negative margins. | journal = J Am Coll Surg | volume = 213 | issue = 5 | pages = 589-95 | month = Nov | year = 2011 | doi = 10.1016/j.jamcollsurg.2011.07.020 | PMID = 21856181 }}</ref>
| >1 mm<ref>{{Cite journal  | last1 = Fitzgerald | first1 = TL. | last2 = Brinkley | first2 = J. | last3 = Zervos | first3 = EE. | title = Pushing the envelope beyond a centimeter in rectal cancer: oncologic implications of close, but negative margins. | journal = J Am Coll Surg | volume = 213 | issue = 5 | pages = 589-95 | month = Nov | year = 2011 | doi = 10.1016/j.jamcollsurg.2011.07.020 | PMID = 21856181 }}</ref>
| 1 cm<ref name=pmid18766404>{{Cite journal  | last1 = Rutkowski | first1 = A. | last2 = Bujko | first2 = K. | last3 = Nowacki | first3 = MP. | last4 = Chmielik | first4 = E. | last5 = Nasierowska-Guttmejer | first5 = A. | last6 = Wojnar | first6 = A. | title = Distal bowel surgical margin shorter than 1 cm after preoperative radiation for rectal cancer: is it safe? | journal = Ann Surg Oncol | volume = 15 | issue = 11 | pages = 3124-31 | month = Nov | year = 2008 | doi = 10.1245/s10434-008-0125-6 | PMID = 18766404 }}</ref>
| [[Gastrointestinal pathology]]
| [[Gastrointestinal pathology]]
|-
|-
|[[Vulvar carcinoma]]
|[[Vulvar carcinoma]]
| 1 cm fresh (0.8 cm fixed)<ref name=pmid21669423>{{Cite journal  | last1 = Palaia | first1 = I. | last2 = Bellati | first2 = F. | last3 = Calcagno | first3 = M. | last4 = Musella | first4 = A. | last5 = Perniola | first5 = G. | last6 = Panici | first6 = PB. | title = Invasive vulvar carcinoma and the question of the surgical margin. | journal = Int J Gynaecol Obstet | volume = 114 | issue = 2 | pages = 120-3 | month = Aug | year = 2011 | doi = 10.1016/j.ijgo.2011.02.012 | PMID = 21669423 }}</ref>
| 1.0 cm (fresh)<ref name=pmid21669423>{{Cite journal  | last1 = Palaia | first1 = I. | last2 = Bellati | first2 = F. | last3 = Calcagno | first3 = M. | last4 = Musella | first4 = A. | last5 = Perniola | first5 = G. | last6 = Panici | first6 = PB. | title = Invasive vulvar carcinoma and the question of the surgical margin. | journal = Int J Gynaecol Obstet | volume = 114 | issue = 2 | pages = 120-3 | month = Aug | year = 2011 | doi = 10.1016/j.ijgo.2011.02.012 | PMID = 21669423 }}</ref>
| 0.8 cm (fixed)<ref name=pmid21669423/>
| [[Gynecologic pathology]]
| [[Gynecologic pathology]]
|-
|-
|[[Malignant melanoma]]
|[[Malignant melanoma]]
| "no minimum safe distance established" - CAP protocol;<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/SkinMelanoma_12protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/SkinMelanoma_12protocol.pdf]. Accessed on: 19 August 2012.</ref> 2 mm - South African consensus<ref name=pmid15344606>{{Cite journal  | last1 = Whitaker | first1 = DK. | last2 = Sinclair | first2 = W. | title = Guideline on the management of melanoma. | journal = S Afr Med J | volume = 94 | issue = 8 Pt 3 | pages = 699-707; quiz 708 | month = Aug | year = 2004 | doi =  | PMID = 15344606 }}</ref>; clinical for [[MIS]]: 5 mm (consensus in 1992)<ref name=pmid22196979>{{Cite journal  | last1 = Kunishige | first1 = JH. | last2 = Brodland | first2 = DG. | last3 = Zitelli | first3 = JA. | title = Surgical margins for melanoma in situ. | journal = J Am Acad Dermatol | volume = 66 | issue = 3 | pages = 438-44 | month = Mar | year = 2012 | doi = 10.1016/j.jaad.2011.06.019 | PMID = 22196979 }}</ref> considered inadequate<ref name=pmid19050971>{{Cite journal  | last1 = Möller | first1 = MG. | last2 = Pappas-Politis | first2 = E. | last3 = Zager | first3 = JS. | last4 = Santiago | first4 = LA. | last5 = Yu | first5 = D. | last6 = Prakash | first6 = A. | last7 = Kinal | first7 = A. | last8 = Clark | first8 = GS. | last9 = Zhu | first9 = W. | title = Surgical management of melanoma-in-situ using a staged marginal and central excision technique. | journal = Ann Surg Oncol | volume = 16 | issue = 6 | pages = 1526-36 | month = Jun | year = 2009 | doi = 10.1245/s10434-008-0239-x | PMID = 19050971 }}</ref>
| [[MIS]]: 5 mm (consensus in 1992)<ref name=pmid22196979>{{Cite journal  | last1 = Kunishige | first1 = JH. | last2 = Brodland | first2 = DG. | last3 = Zitelli | first3 = JA. | title = Surgical margins for melanoma in situ. | journal = J Am Acad Dermatol | volume = 66 | issue = 3 | pages = 438-44 | month = Mar | year = 2012 | doi = 10.1016/j.jaad.2011.06.019 | PMID = 22196979 }}</ref> considered inadequate<ref name=pmid19050971>{{Cite journal  | last1 = Möller | first1 = MG. | last2 = Pappas-Politis | first2 = E. | last3 = Zager | first3 = JS. | last4 = Santiago | first4 = LA. | last5 = Yu | first5 = D. | last6 = Prakash | first6 = A. | last7 = Kinal | first7 = A. | last8 = Clark | first8 = GS. | last9 = Zhu | first9 = W. | title = Surgical management of melanoma-in-situ using a staged marginal and central excision technique. | journal = Ann Surg Oncol | volume = 16 | issue = 6 | pages = 1526-36 | month = Jun | year = 2009 | doi = 10.1245/s10434-008-0239-x | PMID = 19050971 }}</ref>
|| "no minimum safe distance established" - CAP protocol;<ref>URL: [http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/SkinMelanoma_12protocol.pdf http://www.cap.org/apps/docs/committees/cancer/cancer_protocols/2012/SkinMelanoma_12protocol.pdf]. Accessed on: 19 August 2012.</ref>  
| [[Dermatopathology]]
| [[Dermatopathology]]
|-  
|-  
| [[Ductal carcinoma in situ]]
| [[Ductal carcinoma in situ]]
|
| > 2mm<ref>{{Cite journal  | last1 = Dunne | first1 = C. | last2 = Burke | first2 = JP. | last3 = Morrow | first3 = M. | last4 = Kell | first4 = MR. | title = Effect of margin status on local recurrence after breast conservation and radiation therapy for ductal carcinoma in situ. | journal = J Clin Oncol | volume = 27 | issue = 10 | pages = 1615-20 | month = Apr | year = 2009 | doi = 10.1200/JCO.2008.17.5182 | PMID = 19255332 }}</ref>
| > 2mm<ref>{{Cite journal  | last1 = Dunne | first1 = C. | last2 = Burke | first2 = JP. | last3 = Morrow | first3 = M. | last4 = Kell | first4 = MR. | title = Effect of margin status on local recurrence after breast conservation and radiation therapy for ductal carcinoma in situ. | journal = J Clin Oncol | volume = 27 | issue = 10 | pages = 1615-20 | month = Apr | year = 2009 | doi = 10.1200/JCO.2008.17.5182 | PMID = 19255332 }}</ref>
| [[Breast pathology]]
| [[Breast pathology]]
Michael
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