Graduate Thesis Or Dissertation
 

Inter- and Intra-rater Reliability and Agreement in Determining Tumor Margins and Inter-surgeon Agreement in Determining 3 cm Surgical Margins of Subcutaneous Tumors in Dogs

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https://ir.library.oregonstate.edu/concern/graduate_thesis_or_dissertations/rj430c15k

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  • Determination of the gross edge of a tumor is required during patient staging, assessing response to therapy, and for planning and executing surgical resection of locally invasive neoplasms. Disagreement in determination of the gross edge of the tumor is likely to directly affect patient staging, assessing response to therapy and the surgical dose delivered, thus causing morbidity and indirectly affects the outcome. In order to assess such a variation we designed two prospective, randomized, blinded studies assessing inter- and intra-rater reliability and agreement in determining tumor margins using calipers and assessing inter-surgeon agreement in determining 3 cm surgical margins around subcutaneous malignancies in dogs. The findings suggest veterinarians may have poor agreement in determining the gross edge of tumours, which is expected to introduce bias and inconsistency in tumour staging, assessing response to therapy, and surgical margin planning. Additionally, variation among surgeons in delivering a theoretically-uniform surgical dose can be expected to impact patient clinical outcomes, confound interpretation of existing studies, and complicate the design of future studies. Due to the potential consequences for veterinary cancer patients, efforts and future studies are needed to investigate methods to abrogate surgical dosing variation among surgeons to optimize surgical dosing recommendations, and to validate the present findings.
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