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The Journal of Bone and Joint Surgery, Vol 71, Issue 3 370-375, Copyright © 1989 by Journal of Bone and Joint Surgery, Inc
The surgical margin in soft-tissue sarcoma
RS Bell, B O'Sullivan, FF Liu, J Powell, F Langer, VL Fornasier, B Cummings, PN Miceli, N Hawkins, I Quirt and al. et
Sarcoma Site Group, Princess Margaret Hospital, Toronto, Ontario, Canada.
In a retrospective review of 231 patients who were referred to Princess
Margaret Hospital because of a soft-tissue sarcoma in an extremity, 100
patients were identified who had no metastases when they were first seen
and who had been treated by local resection and adjuvant radiation therapy.
Complete data were collected for each patient for the following variables:
age; sex; location of the tumor and its size, grade, depth, and
compartmental status; chemotherapy; and dose of radiation. The surgical
margins were characterized as positive or negative for histological
evidence of disease on the basis of an independent review of the
pathological and operative reports by a surgeon and a radiation oncologist
who were experienced in the management of sarcoma. Cox multivariate
analysis was used to determine which of these variables contributed to
local recurrence and evidence of systemic disease. Adequacy of the margin
of resection was the only variable that was associated with local relapse
(p = 0.0004). The size of the tumor (p = 0.0008) was the major determinant
of the risk of systemic disease.
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