title: Clinical significance of margin status in postoperative radiotherapy for extremity and truncal soft-tissue sarcoma.
abstract: OBJECTIVE
  To evaluate whether adjuvant radiotherapy (RT) in extremity and truncal soft-tissue sarcoma (STS) patients with microscopically positive or close margins after excision can achieve comparable local control to that of excision with negative margin plus RT.
  
  
  METHODS
  A total of 150 patients (111 extremity and 39 trunk cases) treated with conserving surgery and adjuvant RT was analyzed. All surgical margins were classified as being a negative margin or a positive or close margin based on pathologic margin width. RT was delivered with a shrinking-field technique in 150 patients (median, 63 Gy).
  
  
  RESULTS
  All patients were divided into two groups: (A) excision with negative margins plus RT (n = 56) and (B) excision with positive or close margins plus RT (n = 94). Overall, the 5-year local failure-free survival in all patients was 72.9%, and no significant differences were found between the two groups (Group A, 74.7%; Group B, 71.6%). High tumor grade was found to be a significant predictor of local failure. However, Group A was superior to Group B in distant metastasis-free survival (p = 0.02). No significant differences were shown in overall survival between the two groups.
  
  
  CONCLUSIONS
  In our series, margin status did not predict for LF when adjuvant RT was used. We believe that when adjuvant RT is used, re-resection may not be necessary for selected patients with positive or close pathologic margins in the management of extremity and truncal STS patients.
authors.affiliation: Department of Radiation Oncology, Yonsei Cancer Center, Yonsei University College of Medicine, Seoul, Republic of Korea.
authors.forename: Yong Bae
authors.initials: YB
authors.lastname: Kim
authors.forename: Kyu Ho
authors.initials: KH
authors.lastname: Shin
authors.forename: Jinsil
authors.initials: J
authors.lastname: Seong
authors.forename: Jae Kyung
authors.initials: JK
authors.lastname: Roh
authors.forename: Gwi Eon
authors.initials: GE
authors.lastname: Kim
authors.forename: Soo Bong
authors.initials: SB
authors.lastname: Hahn
authors.forename: Chang Ok
authors.initials: CO
authors.lastname: Suh
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D018572:Disease-Free Survival; D005121:Extremities; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D018365:Neoplasm, Residual; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant / Q000009:adverse effects; D012044:Regression Analysis; D012509:Sarcoma / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000401:mortality / Q000473:pathology* / Q000532:radiotherapy* / Q000601:surgery; D017211:Treatment Failure