Low-grade soft-tissue sarcomas: What is an adequate margin for local disease control?

Area of Science:

• Oncology
• Surgical Pathology
• Sarcoma Research

Background:

• Resection margin status is a key predictor of local control in soft-tissue sarcomas (STSs).
• The specific margin width required for adequate local control in low-grade STSs has been less defined.
• This study investigates margin adequacy and its prognostic significance in low-grade STSs.

Purpose of the Study:

• To evaluate the prognostic relevance of margin width in low-grade soft-tissue sarcomas.
• To determine the optimal margin status for achieving local control.
• To assess the impact of margin status on disease-specific mortality.

Main Methods:

• Retrospective analysis of 109 patients with low-grade soft-tissue sarcomas.
• Evaluation of margin status using R-classification, R+1-classification, and metric distance (mm).
• Analysis of local recurrence (LR) rates, disease-specific mortality, and the influence of adjuvant radiotherapy.

Main Results:

• 10-year local recurrence (LR) rates were 6% (R0), 27% (R1), and 54% (R2) by R-classification.
• LR rates by metric distance were 0% (≥2.0 mm), 8% (0.1-1.9 mm), and 38% (0 mm).
• Local recurrence, not margin width, was a significant predictor of poor survival (p=0.003).

Conclusions:

• Negative margins ensure over 90% local control for soft-tissue sarcomas.
• Microscopic margins of ≥2 mm achieve excellent local control in low-grade STSs.
• While margins are critical for local control, local recurrence significantly impacts patient prognosis and survival.