title: Surgical margin and its influence on survival in soft tissue sarcoma.
abstract: BACKGROUND
  The goal of surgeons treating soft tissue sarcoma is to gain local control, to avoid risk of local recurrence and to avoid compromise of the patient's potential survival. The aim of the investigation was to assess the significance of the extent of surgical margin on the chance of death, metastasis and local recurrence.
  
  
  METHODS
  Two hundred and seventy-nine patients who presented with soft tissue sarcoma without metastatic disease were analysed.
  
  
  RESULTS
  The extent of the surgical margin was not clinically or statistically significant in the development of metastatic disease. The presence of a contaminated surgical margin led to a significantly higher rate of local recurrence (as did a narrow surgical margin less than 1 mm). A margin greater than 1 mm allowed a satisfactory outcome in terms of low local recurrence rates. In terms of overall survival, the failure to achieve a wide surgical margin (wide contaminated margin) led to an increased relative death rate. However, when the margin was not contaminated (even if the margin was very close, less than 1 mm), the overall survival rate was similar across all groups. Patients who had radical resections did poorly; they generally belonged to a group in which palliative surgery was carried out, and they showed very high relative metastasis and death rates.
  
  
  CONCLUSIONS
  The present study provides statistically significant evidence that increasing the width of resection improves local control and overall survival.
authors.affiliation: Department of Orthopaedics, The Wesley Medical Centre, Brisbane, Queensland, Australia. iand@wesley.com.au
authors.forename: Ian C
authors.initials: IC
authors.lastname: Dickinson
authors.forename: Duncan J
authors.initials: DJ
authors.lastname: Whitwell
authors.forename: Diane
authors.initials: D
authors.lastname: Battistuta
authors.forename: Bridie
authors.initials: B
authors.lastname: Thompson
authors.forename: Nichola
authors.initials: N
authors.lastname: Strobel
authors.forename: Amit
authors.initials: A
authors.lastname: Duggal
authors.forename: Peter
authors.initials: P
authors.lastname: Steadman
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012509:Sarcoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery*; D016019:Survival Analysis