BACKGROUND: Sarcomas require a wide margin of resection including a cuff of normal tissue to minimize the risk of local recurrence. The amount of tissue that constitutes a wide margin is unclear in the literature. QUESTIONS/PURPOSES: We therefore determined whether a close resection margin for soft tissue sarcoma resulted in an increased incidence of locally recurrent disease and whether additional factors, including radiation therapy, outside biopsies, and tumor biology, affected the risk of local recurrence. METHODS: We retrospectively reviewed 117 patients with soft tissue sarcomas resected with negative margins from 2001 to 2007. Gross specimens were inked and the closest macroscopic margins were sent for microscopic examination. Resection margins were categorized as less than 1 mm, 1-5 mm, or greater than 5 mm. We evaluated additional factors that might influence local recurrence, including radiation therapy, outside biopsies, sarcoma type, grade, and stage at presentation, and development of metastatic disease. RESULTS: Four of 117 patients (3.4%) developed local recurrence. The incidence of local recurrence was similar in patients with less than 1-mm margins and greater than 1-mm margins: two of 45 patients (4.4%) and two of 64 patients (3.1%), respectively. Due to the low number of local recurrences, quantitative margin extent and the other factors evaluated did not affect local recurrence. CONCLUSIONS: The extent of a margin necessary to prevent local recurrence of soft tissue sarcoma remains unclear as the power of our study was limited by the low number of local recurrences. Relatively low local recurrence rates can be achieved even with close margins. LEVEL OF EVIDENCE: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
BACKGROUND:Sarcomas require a wide margin of resection including a cuff of normal tissue to minimize the risk of local recurrence. The amount of tissue that constitutes a wide margin is unclear in the literature. QUESTIONS/PURPOSES: We therefore determined whether a close resection margin for soft tissue sarcoma resulted in an increased incidence of locally recurrent disease and whether additional factors, including radiation therapy, outside biopsies, and tumor biology, affected the risk of local recurrence. METHODS: We retrospectively reviewed 117 patients with soft tissue sarcomas resected with negative margins from 2001 to 2007. Gross specimens were inked and the closest macroscopic margins were sent for microscopic examination. Resection margins were categorized as less than 1 mm, 1-5 mm, or greater than 5 mm. We evaluated additional factors that might influence local recurrence, including radiation therapy, outside biopsies, sarcoma type, grade, and stage at presentation, and development of metastatic disease. RESULTS: Four of 117 patients (3.4%) developed local recurrence. The incidence of local recurrence was similar in patients with less than 1-mm margins and greater than 1-mm margins: two of 45 patients (4.4%) and two of 64 patients (3.1%), respectively. Due to the low number of local recurrences, quantitative margin extent and the other factors evaluated did not affect local recurrence. CONCLUSIONS: The extent of a margin necessary to prevent local recurrence of soft tissue sarcoma remains unclear as the power of our study was limited by the low number of local recurrences. Relatively low local recurrence rates can be achieved even with close margins. LEVEL OF EVIDENCE: Level III, therapeutic study. See Guidelines for Authors for a complete description of levels of evidence.
Authors: Brian P Rubin; Kumarasen Cooper; Christopher D M Fletcher; Andrew L Folpe; Francis H Gannon; Jennifer L Hunt; Alexander J Lazar; Anthony G Montag; Terrance D Peabody; Raphael E Pollock; John D Reith; Stephen J Qualman; Andrew E Rosenberg; Sharon W Weiss; Thomas Krausz Journal: Arch Pathol Lab Med Date: 2010-04 Impact factor: 5.534
Authors: Eduardo N Novais; Bahtiyar Demiralp; Joseph Alderete; Melissa C Larson; Peter S Rose; Franklin H Sim Journal: Clin Orthop Relat Res Date: 2010-11 Impact factor: 4.176
Authors: Alessandro Gronchi; Salvatore Lo Vullo; Chiara Colombo; Paola Collini; Silvia Stacchiotti; Luigi Mariani; Marco Fiore; Paolo Giovanni Casali Journal: Ann Surg Date: 2010-03 Impact factor: 12.969
Authors: BoKyong Kim; Yen-Lin E Chen; David G Kirsch; Saveli I Goldberg; Wendy Kobayashi; Jong Hyun Kung; John A Wolfgang; Karen Doppke; Andrew E Rosenberg; G Petur Nielsen; Kevin A Raskin; Dempsey S Springfield; Joseph H Schwab; Mark C Gebhardt; Sam S Yoon; Francis J Hornicek; Thomas F DeLaney Journal: Int J Radiat Oncol Biol Phys Date: 2009-12-16 Impact factor: 7.038
Authors: Ali Al Yami; Anthony M Griffin; Peter C Ferguson; Charles N Catton; Peter W M Chung; Robert S Bell; Jay S Wunder; Brian O'Sullivan Journal: Int J Radiat Oncol Biol Phys Date: 2010-01-07 Impact factor: 7.038