The prognostic significance of margin width for extremity and trunk sarcoma

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.