Tumor Surgery Margins: A Preoperative Planning Worksheet

Caregivers considering first surgery, re-excision after incomplete margins, or referral for a tumor where local control depends on planned tissue margins.

Connect histology, grade, imaging, biopsy track, anatomic barriers, reconstruction, specimen orientation, and backup options before the first definitive incision.

Bring cytology, biopsy, pathology, imaging, photographs, prior operative notes, and the exact location of any previous incision or drain. Ask whether referral before surgery could preserve local-control options. “Remove the lump” is not a complete oncologic plan. If instructions conflict, pause and ask the treating clinic to reconcile them; do not choose the instruction that seems easiest.

1. Write the confirmed or suspected tumor type and what is still unknown.
2. Ask what lateral and deep tissue planes are intended and which anatomy limits them.
3. Confirm the biopsy scar and any contaminated field will be included in the resection.
4. Discuss closure, graft, flap, drain, limb function, and what happens if safe margins are not possible.
5. Agree on specimen orientation, ink, separate margins, photographs, and pathology request details.
6. Plan the response to complete, close, incomplete, or unassessable margins before results arrive.

Before surgery, track growth, ulceration, pain, mobility, and organ function. After surgery, follow the individualized discharge plan and record incision alignment, swelling, discharge, comfort, eating, toileting, and protective-device use. Write observations in neutral terms with date and time. A home log supports clinical decisions but does not authorize a medication change or replace examination, laboratory testing, imaging, or emergency triage.

Call for increasing redness, swelling, discharge, odor, opening, worsening pain, or functional loss. Emergency care is appropriate for collapse, breathing difficulty, uncontrolled bleeding, very pale gums, or a rapidly enlarging abdomen. When urgent transport is advised, bring the current medication list and call ahead if that does not delay departure.