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Master Thesis

Analyse de la rétraction des tumeurs et des marges après l’exérèse chirurgicale de lésions cutanées

Abstract : 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 analyze the retraction of the specimens, the lesions and the margins of cutaneous specimens. Methods : in this observational, prospective and monocentric study, patients who had an excision of a skin tumour between January 2013 and July 2014 were randomly included. Before excision, the surgeon collected the following data: localization of the lesion, specimen length and width in millimetres, lesion length and width in millimetres and the smallest margin in millimetres designed on a schema. After formalin fixation, the pathologist collected the same information and the duration of formalin fixation. Then with a microscope, he measured the smallest histological margin and noted whether the localization of the smallest margin was the same as the smallest margin indicated by the surgeon. The percentage of retraction was calculated for the various measures. Results : a total of 104 patients was included. There were 52% male with a mean age of 68.3 years. Seventy-eight percent of the lesions were malignant (51% were basal cell carcinoma, 11% squamous cell carcinoma and 8% melanoma). The retraction of the area of the specimen (29%) was significantly greater than the retraction of the tumour (21%) (p<0,001). The retraction of the smallest margin was 10%. On multivariate analysis, the localization 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 localization of the smallest margin in 55% of cases. Discussion : our study provided additional data regarding the retraction of the tumours and margins. We demonstrated that the retraction of the specimen’s area was greater than that of the lesion’s area. 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 understanding of the sufficiency of the margins.
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Master Thesis
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Submitted on : Friday, November 29, 2019 - 11:45:08 AM
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Marine Sevray. Analyse de la rétraction des tumeurs et des marges après l’exérèse chirurgicale de lésions cutanées. Life Sciences [q-bio]. 2019. ⟨dumas-02386318⟩

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