title: A histological positive margin after surgery is correlated with high local re-recurrence rate in patients with recurrent myxofibrosarcoma.
abstract: OBJECTIVE
  Myxofibrosarcoma has high frequency of local recurrence after surgery. To determine an optimal treatment for recurrent tumors, clinical features of recurrent cases should be characterized.
  
  
  METHODS
  We performed a retrospective analysis of 30 patients with recurrent myxofibrosarcoma who underwent surgery between 1999 and 2008.
  
  
  RESULTS
  A negative margin after surgery was achieved in only 12 patients (40.0%). The 5-year re-recurrence free-survival rate was 31.7%. The 5-year re-recurrence free survival for those with positive histological margin and those with negative margin were 9.8% and 62.3%, respectively, which indicated that a positive margin was the significant predictor of poor prognosis (P = 0.006). In 21 patients with recurrent myxofibrosarcoma in the extremities, 10 patients (47.6%) ultimately underwent amputation in the follow-up period and the 5-year amputation-free survival rate was 62.5%. The 5-year metastasis-free survival rates and the 5-year overall survival rates were 84.8% and 83.6%, respectively.
  
  
  CONCLUSIONS
  In this study, the majority of recurrent cases could not achieve negative margins; notably, a positive margin is a significant poor prognostic indicator of local re-recurrence in patients with recurrent myxofibrosarcoma. To control local recurrence of myxofibrosarcoma was extremely difficult and amputation is often needed in the extremity cases.
authors.affiliation: Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo.|Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Kazutaka
authors.initials: K
authors.lastname: Kikuta
authors.affiliation: Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo.
authors.forename: Robert
authors.initials: R
authors.lastname: Nakayama
authors.affiliation: Division of Pathology and Clinical Laboratory, National Cancer Center Hospital, Tokyo.
authors.forename: Akihiko
authors.initials: A
authors.lastname: Yoshida
authors.affiliation: Department of Pathology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Aya
authors.initials: A
authors.lastname: Sasaki
authors.affiliation: Department of Pathology, Keio University School of Medicine, Tokyo, Japan.
authors.forename: Kaori
authors.initials: K
authors.lastname: Kameyama
authors.affiliation: Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Hirokazu
authors.initials: H
authors.lastname: Chuman
authors.affiliation: Division of Musculoskeletal Oncology, National Cancer Center Hospital, Tokyo.
authors.forename: Akira
authors.initials: A
authors.lastname: Kawai
authors.affiliation: Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo.
authors.forename: Masaya
authors.initials: M
authors.lastname: Nakamura
authors.affiliation: Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo.
authors.forename: Morio
authors.initials: M
authors.lastname: Matsumoto
authors.affiliation: Department of Orthopaedic Surgery, Keio University School of Medicine, Tokyo.
authors.forename: Hideo
authors.initials: H
authors.lastname: Morioka
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D005260:Female; D005350:Fibroma / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D006801:Humans; D023821:Limb Salvage / Q000379:methods*; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D015996:Survival Rate
keywords: amputation; limb salvage; local recurrence; myxofibrosarcoma; surgical margin