Surgical margins in the management of extremity soft tissue sarcoma

Standard treatment of localized soft tissue sarcoma should include surgical resection, which can be performed alone or in combination with perioperative radiotherapy and/or chemotherapy. The purpose of surgical intervention is to excise the tumor completely and to prevent disease relapse. Surgeons should remove the tumor with a sufficiently wide margin of the surrounding normal tissue; however, it is also necessary to pay attention to maximizing postoperative physical function. In order to balance the two competing goals, surgeons have been working to establish better methods for determining surgical margins and better guidelines for achieving adequate margins. At the present time, limb-sparing surgery is the mainstay of surgical treatment for soft tissue sarcomas of the extremities. In this article, we review the fundamentals of surgical margins as they pertain to soft tissue sarcomas and make recommendations for surgical treatment based upon current literature.