Impact of the smallest surgical margin on local control in soft tissue sarcoma

Abstract

Surgical margin had independent prognostic value for local control. A surgical margin of 2-3 cm provided reasonable local control of soft tissue sarcoma, even without radiotherapy. Radiotherapy is recommended for smaller margins, irrespective of tumour grade.

Microvascular reconstructions after extensive soft tissue sarcoma resections in the upper limb

“…Oncological results were comparable to studies with similar patient material [9]. Other works on upper extremity STS have reported rates of local recurrence of 17-25% with variable lengths of follow up [11,12,23].…”

“…The required surgical margins of 2-3cm [9] of tumour-free tissue frequently cause large defects, and local or free flaps are often required to achieve tension-free wound closure or to reconstruct tissue defects. Free flap reconstruction is needed in 11-18% of patients undergoing limb-sparing surgery for upper extremity STS [10][11][12].…”

Extremity and Trunk Soft-Tissue Sarcomas

“…Large series that include all sarcoma sites have identified an increased risk associated with larger size of the primary tumor, specifically tumors greater than 10 cm versus those smaller [12,17]. A series from Finland showed size as a continuum of risk for local failure with small tumors less than 3.8 cm having a 87.4% local control compared to 74.2% for tumors 3.8-7.0 cm and 67% for tumors greater than 7 cm [8]. The author indicates, however, that with increasing size there was a [8] 78.6% 70.9% 0.147 MDACC [12] 81% UE; 87% LE 84% ns Korea [42] 64.3% UE; 77.8% LE 81.2% ns UE upper extremity, LE lower extremity significant and corresponding decrease in the surgical margin.…”

“…Multiple tumor criteria have an impact on the local control and metastatic risk in extremity and truncal sarcomas; these include tumor location, histopathology, tumor grade, and tumor size [4][5][6][7][8].…”

Are Radical Compartmental Resections for Retroperitoneal Sarcomas Justified?

“…What constitutes an adequate surgical margin has been the subject of ongoing debate, not only in sarcoma but in other malignancies as well. 23,24 Achieving negative microscopic margins for RPS resections is challenging. To our knowledge, there are no good guidelines outlining a standardized and reproducible method for the evaluation of margins for RPS.…”