The prognostic significance of margin width for extremity and trunk sarcoma

✍ Scribed by Mark D. Mc Kee; Dong Feng Liu; John J. Brooks; John F. Gibbs; Deborah L. Driscoll; William G. Kraybill

• Publisher: John Wiley and Sons
• Year: 2004
• Tongue: English
• Weight: 108 KB
• Volume: 85
• Category: Article
• ISSN: 0022-4790
• DOI: 10.1002/jso.20009

✦ Synopsis

Abstract

Background and Objectives

To evaluate the significance of resection margin for soft tissue sarcoma (STS), we determined local recurrence‐free interval (LRFI), distant metastases‐free interval (DMFI), and overall survival (OS) for primary extremity and truncal STS with clear margins (≥10 mm), close margins (1–9 mm), and positive margins (0 mm).

Methods

Patients were evaluated via review of charts and tumor specimens.

Results

Among 111 patients, tumors were predominantly high grade (86%), ≥5 cm (76%), and deep (81%). A minority of patients received adjuvant radiation (38%) and/or adjuvant chemotherapy (34%). Margin width was ≥10 mm (48%), 1–9 mm (40%), or 0 mm (12%). Margins ≥10 mm were less common for large (P = 0.009) or deep (P = 0.02) tumors. By multivariate analysis, independent factors for LRFI were tumor size (P = 0.04) and margin width (P = 0.03). Independent factors related to DMFI were tumor grade (P = 0.002), size (P = 0.007), and patient age (P = 0.02). Independent factors relating to OS were tumor grade (P = 0.001), size (P = 0.004), and depth (P = 0.03).

Conclusions

Margins ≥10 mm independently predicted longer LRFI and are optimal for extremity STS resection. Adjuvant radiotherapy should be considered for all STS resected with margins <10 mm, and margin width should be considered when reporting and interpreting LR outcomes for these patients. J. Surg. Oncol. 2004;85:68–76. © 2004 Wiley‐Liss, Inc.