Surgical margins for soft-tissue sarcoma

A retrospective analysis was done of the rates of local recurrence in eighty-one patients in whom soft-tissue sarcomas in the extremities and the trunk were treated by surgery only. The minimum length of follow-up was six years or until death. The surgical margin was wide in all patients according to the definition of the surgical staging system of Enneking et al., but we defined three types of wide margin. None of them included a whole anatomical compartment, so that the radical resection, as defined by the surgical staging system, was excluded from the study. The crude rates of local recurrence in the three subgroups that were studied differed significantly. There was no correlation between the rate of local recurrence and the histological grade of malignancy. Our findings suggest that the subclassification of the wide margin that we have applied to the surgical staging system of Enneking et al. is of value. The low rates of recurrence (less than 10 per cent) for subcutaneous lesions, and intramuscular lesions that were treated by primary myectomy, were comparable with those of radical resections and usually were followed by minor loss of function. The higher rate of recurrence (30 per cent) for the third subgroup, which included deep tumors that were not treated by myectomy, was comparable with the rates found in other studies.