Practical approach to clinically diagnosed equine sarcoids using diode laser excision: Results and long‐term outcome

Summary Background A recent systematic review reported insufficient evidence to conclude on a preferred treatment for equine sarcoids. Diode laser excision of sarcoids is now one of the most common first‐line treatments in UK practices but there is limited evidence of its long‐term efficacy. Objectives This study aimed to evaluate the overall recurrence rate of sarcoids, the recurrence rate at the site of surgical excision (SSE) and at different anatomical sites (DAS) after diode laser excision in clinical practice. Study Design Retrospective case series. Methods Medical records for horses that underwent surgical excision for clinically diagnosed sarcoid lesions using a diode laser between 2018 and 2023 by a single experienced ECVS diplomate were retrospectively reviewed. Horses that were already receiving additional sarcoid treatment at the time of surgery, histological exclusion of sarcoids or those that were unavailable for follow‐up were excluded. Signalment, lesion type, size and location, histology results, surgical complications, recurrence of sarcoid(s) at the SSE and at DAS and time of recurrence were recorded and analysed. Results One hundred and twenty‐four horses with 218 lesions were included with a median follow‐up of 32 months [6.0–71.2]. The recurrence rate for an individual sarcoid at the SSE was low (6.4%), and the overall recurrence rate per horse (at least one recurrence anywhere) was 20.5%. Obtaining histological tumour‐free margins (TFM) was associated with a significant decrease in recurrence rate at SSE (0.0% vs. 11.5%, Fisher test: p = 0.01). Main Limitations Retrospective study design, not all lesions were confirmed histologically. Conclusion Diode laser removal is an effective treatment for equine sarcoids, with an overall low recurrence rate observed. Recurrence at the SSE was significantly reduced if TFM were obtained on the excised lesion. Careful selection of lesions and sufficient margins appear to be important for treatment success.