title: Invasive vulvar carcinoma and the question of the surgical margin.
abstract: OBJECTIVE
  To assess the discrepancy between width of surgical margin measured with the naked eye/ruler by a surgeon before removing an invasive vulvar carcinoma, and width of margin measured under microscope by pathologist after fixation of the resected lesion with formalin. Potential relationships between discrepancy and disease recurrence were also investigated.
  
  
  METHODS
  This prospective study was conducted with resected lesions from 86 women who underwent surgery for primary/recurrent invasive vulvar carcinoma. After the surgeon removed the lesions surrounded by 1-2-cm margins, the pathologist determined margin width at the 4 cardinal points of 86 lesions (for a total of 344 margin assessments), first macroscopically and then under the microscope.
  
  
  RESULTS
  A safety margin of 0.8 cm on microscopic view was achieved in 83% of cases (112 of 135) when the macroscopic measurement was 1cm, in 91% of cases (58 of 64) when it was 1.5 cm, and 98% of cases (105 of 107) when it was 2 cm.
  
  
  CONCLUSIONS
  There was a small discrepancy between the surgeon's intent and the microscopic margin measurement, mostly related to tissue shrinkage. A 1-cm surgical margin corresponded to a 0.8-cm margin in microscopic view (the "safe margin") in most cases.
authors.affiliation: Department of Obstetrics and Gynecology, Sapienza University, Rome, Italy.
authors.forename: Innocenza
authors.initials: I
authors.lastname: Palaia
authors.forename: Filippo
authors.initials: F
authors.lastname: Bellati
authors.forename: Marco
authors.initials: M
authors.lastname: Calcagno
authors.forename: Angela
authors.initials: A
authors.lastname: Musella
authors.forename: Giorgia
authors.initials: G
authors.lastname: Perniola
authors.forename: Pierluigi B
authors.initials: PB
authors.lastname: Panici
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002277:Carcinoma / Q000473:pathology / Q000601:surgery*; D005260:Female; D013509:Gynecologic Surgical Procedures / Q000379:methods; D006801:Humans; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D011446:Prospective Studies; D014846:Vulvar Neoplasms / Q000473:pathology / Q000601:surgery*