Achieving a negative margin may be essential for optimizing both local control and survival in patients with soft tissue sarcoma treated with radiotherapy, according to a study published in The Oncologist.
However, absolute quantitative width of the negative margin does not significantly influence outcome, and attempts at wide margins of resection may be unnecessary. Rima Ahmad, MD, and fellow researchers from the Massachusetts General Hospital in Boston conducted a retrospective review of 382 patients with localized extremity or truncal soft tissue sarcoma who had undergone limb-sparing surgery and radiotherapy from 1983 to 2010. They analyzed for the significance of resection margin status and quantitative margin width on outcomes.
The researchers found that surgical margins were positive in 68 patients and negative in 314 patients. Among 235 patients with a reported quantitative margin width, the width of the negative margin was 1 mm or less in 128 patients, more than 1 mm and 5 mm or less for 79 patients, and more than 5 mm for 28 patients.
With a median follow-up of 82 months, they also found that local recurrence rates were 5.4% for margin-negative patients and 11.8% for margin-positive patients. They found no differences in the rates of local or distant recurrence, or if the surgical margin was negative, of any survival outcome based on the quantitative width.
“The conclusions drawn from this study must not be applied to those patients undergoing surgery alone as the local treatment of their soft tissue sarcoma, in which case wider margins of resection may be necessary,” the authors concluded.
- Ahmad R, Jacobson A, Hornicek F, et al. The Width of the Surgical Margin Does Not Influence Outcomes in Extremity and Truncal Soft Tissue Sarcoma Treated With Radiotherapy. 20 Jul 2016. The Oncologist. doi: 10.1634/theoncologist.2015-0534. [Epub ahead of print.]