title: [Surgical margins in soft tissue sarcoma of the extremities].
abstract: Negative surgical margins (R0 resection) play a key role in the prevention of local recurrences of soft tissue sarcoma of the extremities in the multimodal therapy concept. The prognostic relevance for long-term survival is still under dispute. Despite the fact that numerous recommendations and guidelines have existed for over 100 years, strong evidence-based data from prospective randomized studies are still not available today. These studies should include parameters like tumor localization, subtype and biological aggressiveness. Recommendations as to surgical therapy diverge considerably. They range from amputation and compartment resection to centimetre and millimetre surgical margins. The present article analyses currently available data and definitions and discusses the impact on functional restriction, lymph drainage, local recurrence and the perioperative irradiation field. In the absence of surgical standards, it is doubtful whether existing studies and multicenter trials currently underway are valid. Close co-operation between surgeon and pathologist is imperative to further substantiate the significance of histological examinations and resection margins.
authors.affiliation: Klinik für Plastische Chirurgie und Schwerbrandverletzte, Handchirurgiezentrum, Operatives Referenzzentrum für Weichgewebssarkome, Berufsgenossenschaftliches Universitätsklinikum Bergmannsheil, Ruhr-Universität Bochum, Bürckle-de-la Camp Platz 1, 44789 Bochum, Deutschland. hans-ulrich.steinau@bergmannsheil.de
authors.forename: H-U
authors.initials: HU
authors.lastname: Steinau
authors.forename: L
authors.initials: L
authors.lastname: Steinsträsser
authors.forename: S
authors.initials: S
authors.lastname: Langer
authors.forename: I
authors.initials: I
authors.lastname: Stricker
authors.forename: O
authors.initials: O
authors.lastname: Goertz
mesh_terms: D000671:Amputation, Surgical; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D005121:Extremities / Q000601:surgery*; D006801:Humans; D018482:Muscle, Skeletal / Q000473:pathology / Q000601:surgery; D020360:Neoadjuvant Therapy; D009364:Neoplasm Recurrence, Local / Q000188:drug therapy / Q000473:pathology* / Q000517:prevention & control* / Q000532:radiotherapy; D009367:Neoplasm Staging; D018365:Neoplasm, Residual / Q000188:drug therapy / Q000473:pathology* / Q000517:prevention & control* / Q000532:radiotherapy; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012509:Sarcoma / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000188:drug therapy / Q000473:pathology* / Q000532:radiotherapy / Q000601:surgery*