title: The prognostic significance of margin width for extremity and trunk sarcoma.
abstract: OBJECTIVE
  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 (> or =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%), > or =5 cm (76%), and deep (81%). A minority of patients received adjuvant radiation (38%) and/or adjuvant chemotherapy (34%). Margin width was > or =10 mm (48%), 1-9 mm (40%), or 0 mm (12%). Margins > or =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 > or =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.
authors.affiliation: Division of Surgical Oncology, Roswell Park Cancer Institute and State University of New York, Elm & Carlton Streets, Buffalo, NY 14263, USA.
authors.forename: Mark D
authors.initials: MD
authors.lastname: McKee
authors.forename: Dong Feng
authors.initials: DF
authors.lastname: Liu
authors.forename: John J
authors.initials: JJ
authors.lastname: Brooks
authors.forename: John F
authors.initials: JF
authors.lastname: Gibbs
authors.forename: Deborah L
authors.initials: DL
authors.lastname: Driscoll
authors.forename: William G
authors.initials: WG
authors.lastname: Kraybill
mesh_terms: D017024:Chemotherapy, Adjuvant; D005121:Extremities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012307:Risk Factors; D012509:Sarcoma / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D016019:Survival Analysis; D016896:Treatment Outcome