Tumor Seeding Risks With Cancer Surgery

In the Literature

Orjefelt E, MacKay JRD, Bowlt Blacklock KL. Glove and instrument handling in small animal oncological surgeries: a survey. J Small Anim Pract. 2025;66(7):477-483. doi:10.1111/jsap.13852

The Research …

Many surgical oncology protocols (eg, changing surgical gloves and instruments after tumor removal and before wound closure) help prevent tumor seeding, which can occur when cancer cells are dislodged during surgical or diagnostic procedures.¹ Disrupted cancer cells can colonize distant sites or adhere to and grow in tissue they come into contact with; many such cases have been reported in human and veterinary medicine.^2,3

This study used an online survey to assess beliefs of veterinary surgeons regarding the potential for gloves and surgical instruments to act as vehicles for tumor seeding and whether they perceived a need for specific protocols to address this potential risk. Data collected included number of years in practice, specialized training, practice type, and percent of oncologic surgeries performed. Of the 194 respondents, 89.1% changed gloves and 87.6% changed instruments when performing oncologic surgery. A similar survey involving human general surgeons found that 52% of respondents changed gloves and 40% changed instruments when performing oncologic surgery.⁴

In this study, most veterinary surgeons indicated belief that gloves and surgical instruments can be contaminated with malignant cells. Fewer protocols were reported to protect wound edges from tumor seeding, with 34.9% of respondents protecting edges during open surgeries and 62.1% during laparoscopic surgeries. Surgeons with more experience and advanced training or those working in referral hospitals were more likely to change their gloves and instruments, possibly due to increased awareness of tumor seeding and access to more resources.

The authors concluded that surgeons in general have a high level of awareness of and strong interest in evidence-based protocols to reduce contamination in oncologic surgery. Although more research is needed to determine which surgeries should require changing gloves, a cautious approach is recommended.

… The Takeaways

Key pearls to put into practice:

• Neoplastic cells can survive on gloves and instruments and act as mechanical vehicles, potentially contributing to tumor seeding, which may result in tumor recurrence. Changing gloves and instruments prior to incision closure when performing oncologic surgery is common among surgeons and may reduce risk for tumor seeding.

• Training and consulting with experienced surgeons can help increase awareness of tumor seeding and aid in the adoption of prevention protocols.

• Using protocols like specimen retrieval bags, minimal tumor manipulation, lavage, and retractors can help protect wound edges from tumor seeding and contamination during open and laparoscopic oncologic surgeries.