ID | 60539 |
FullText URL | |
Author |
Fujiwara, Tomohiro
Department of Orthopaedic Surgery, Okayama University Graduate School of Medicine, Dentistry, and Pharmaceutical Sciences
ORCID
Kaken ID
Stevenson, Jonathan
Oncology Service, The Royal Orthopaedic Hospital
Parry, Michael
Oncology Service, The Royal Orthopaedic Hospital
Tsuda, Yusuke
Oncology Service, The Royal Orthopaedic Hospital
Kaneuchi, Yoichi
Oncology Service, The Royal Orthopaedic Hospital
Jeys, Lee
Oncology Service, The Royal Orthopaedic Hospital
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Abstract | Objectives
There remains no consensus on what constitutes an adequate margin of resection for non-infiltrative soft-tissue sarcomas (STSs). We aimed to investigate the role of resection margins in millimetres for non-infiltrative STSs.
Methods
502 patients who underwent surgical resection for a localized, non-infiltrative, high-grade STSs were studied. The prognostic significance of margin width was analysed and compared with the conventional R- and R+1-classification of surgical margins.
Results
The overall local recurrence (LR) rate was 13%; 9% and 27% with negative and positive margins, respectively (p < 0.001). In patients with negative margins, the LR rates were greater than 10% in patients with margins ≤5.0 mm but reduced to less than 4% with margins >5.0 mm. When classified by the R- (or R+1)-classification, the 5-year cumulative LR incidence was 8%, 23% (16%), and 31% for R0, R1, and R2, respectively, which did not stratify the LR risk with negative margins. On the other hand, an accurate risk stratification was possible by metric distance; the 5-year cumulative incidence of LR was 29%, 10%, and 1% with 0 mm, 0.1–5.0 mm, and >5.0 mm, respectively (p < 0.001). This classification also stratified the LR risk in patients with or without adjuvant radiotherapy.
Conclusion
While a negative margin is essential to optimize local control in patients with non-infiltrative STSs, surgical margin width greater than 5 mm minimises the risk of local failure regardless of the use of adjuvant radiotherapy.
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Keywords | Soft-tissue sarcoma
Non-infiltrative subtype
Margin
Local recurrence
Prognosis
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Note | This is an Accepted Manuscript of an article published by European Society of Surgical Oncology.
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Published Date | 2020-06-18
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Publication Title |
EJSO - European Journal of Surgical Oncology
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Volume | volume47
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Issue | issue2
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Publisher | European Society of Surgical Oncology
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Start Page | 429
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End Page | 435
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ISSN | 0748-7983
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NCID | AA10516435
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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File Version | author
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DOI | |
Related Url | isVersionOf https://doi.org/10.1016/j.ejso.2020.06.020
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