Does the extent of the surgical margin affect the likelihood of local recurrence in Patnaik grade I or II cutaneous mast cell tumours?

Abstract

PICO question Does the extent of the surgical margin affect the likelihood of local recurrence in Patnaik grade I or II cutaneous mast cell tumours?   Clinical bottom line Category of research question Treatment The number and type of study designs reviewed Eight papers were critically reviewed. Five were retrospective case series, two prospective clinical trials, and one prospective case series Strength of evidence Low Outcomes reported Sequin et al. (2001) reported a local recurrence rate of 5%, but this study is 20 years old. In the studies of Simpson et al. (2004), Fulcher et al. (2006), Pratschke et al. (2013), Saunders et al. (2020), and Itoh et al. (2021), no local recurrence was observed in grade I and II mast cell tumours, while in the Milovancev et al. (2019) study, only 1/30 low-grade cutaneous mast cell tumors developed local recurrence. Therefore, there is some evidence that conservative surgical excision is sufficient to achieve local control with low recurrence rates Conclusion There is increasing evidence in the literature for conservative surgical excision of grade I and II MCTs, but because the quality of evidence is low, no clear recommendations can be made. Further studies are needed to determine recommendations for surgical excision of cutaneous MCTs based on the biological characteristics of the tumour and the completeness of histologic margins   How to apply this evidence in practice The application of evidence into practice should take into account multiple factors, not limited to: individual clinical expertise, patient’s circumstances and owners’ values, country, location or clinic where you work, the individual case in front of you, the availability of therapies and resources. Knowledge Summaries are a resource to help reinforce or inform decision making. They do not override the responsibility or judgement of the practitioner to do what is best for the animal in their care.