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Veterinary Surgical Oncology


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time (Porcellato et al. 2019). In another study, grade using the canine criteria was prognostic for metastasis but no local recurrence (Romanelli et al. 2008). In a study of cats with soft tissue sarcomas that included FISAS and non‐FISAS, modification of the criteria used to grade soft tissue sarcomas in canines was applied and was prognostic for survival time: median survival time for cats with low‐grade tumors was 900 days, with intermediate grade 514 days, and high grade 283 days (Dobromylskyj et al. 2021). In this modified system, mitotic score and tumor necrosis score were the same as in canine tumors, but inflammation score was used instead of tumor cell differentiation score (Dobromylskyj et al. 2021).

Photo depicts (a) wide excision of a feline injection-site-associated sarcoma. The skin incision has been performed around the subcutaneous tumor. (b) En bloc resection of tumor mass and surrounding tissue barrier. (c) Visible dorsal spinous processes (arrows) of cervical vertebrae after tumor removal. (d) Closure in layers with simple interrupted suture patterns. Blue nylon skin sutures are visible. Photo depicts radical excision of a feline injection-site-associated sarcoma.

      It is important to consider that the margin size will alter directly after removal of the specimen. Significant decreases in surgical margin length in FISASs specimens occur immediately following excision (prior to formalin fixation). Median tumor volume decreases significantly between in vivo and ex vivo assessments regardless whether measurements are obtained from 2‐D or 3‐D CT images. Subgross evaluation of tumor‐free margins from on‐slide grossly normal surgical margins to pathologist‐reported histologic tumor‐free margin overestimates the actual (histologic) tumor‐free margins (Terry et al. 2016, 2017).

      Radical surgery is easier with the guidance of advanced imaging in the form of CT or MRI compared to manual palpation. Preoperatively the skin is marked as required for sufficient margins. Available amount of skin for closure has to be assessed preoperatively. If insufficient, a skin flap can be used (Montinaro et al. 2015), or skin stretcher can help to recruit extra skin in two to three days. Changes in the muscular form according to the forelimb positioning must be appreciated. It is important to have an in‐depth anatomical knowledge of the interscapular region of the feline patient to approach the study of any pathology located there and, in particular, to set up an appropriate therapy for the FISASs (Longo et al. 2015).

      In a study of 76 cats with vaccine‐associated