Cancer Reconstructive Surgery
نویسنده
چکیده
Background: Resection of oral, cutaneous and subcutaneous tumors now occupies a significant portion of our soft tissue surgery referral practice. Cutaneous mast cell tumors are the most common skin tumor in dogs, comprising up to 21% of cutaneous malignancies. The incidence of soft tissue sarcomas is only slightly less, with these invasive malignancies constituting approximately 15% of all skin and subcutaneous tumors in dogs. Interestingly, oral malignancies, soft tissue sarcomas (STS) and mast cell tumors (MCT) are all characterized by a high rate of local recurrence unless they are excised with wide margins of normal tissue. This biological behavior led to the recommendation that STS and MCT should be removed with a minimum of 2 cm lateral skin margins, and including a deep fascial plane. Oral tumors are removed with a 1-2 cm margin which can cause significant morbidity due to the location. Adherence to this dogma led to a need for advanced reconstructive procedures to repair tissue defects created by aggressive resections. Tumors on the limbs were often treated by amputation. Over the last decade, this trend has reversed. With the increasing availability of radiation therapy and novel chemotherapeutic agents, oncologists are now requesting cytoreductive therapy in lieu of wide resection, preserving limb function and avoiding reconstructive procedures by using adjunctive therapies to prevent tumor recurrence. Nonetheless, complete resection and tissue reconstruction often remains the most economical, single stage therapy for locally aggressive neoplasia.
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