C. H. Gerrand1,2, Jay S. Wunder3,2, Rita A. Kandel4,5, Brian O’Sullivan6,7, Charles Catton6,7, R. S. Bell8,2, Anthony M. Griffin9,2, Aileen M. Davis10,11
1Clinical Fellow.
2Suite 476
3Orthopaedic Surgeon
4Department of Pathology, 6th Floor, Mount Sinai Hospital, 600 University Avenue, Toronto, Canada M5G 1X5.
5Pathologist
6Department of Radiation Oncology, Princess Margaret Hospital, the University Health Network, 5th floor, 610 University Avenue, Toronto, Canada M56 2M9.
7Radiation Oncologist
8Director
9Research Assistant.
10Room 1119, Toronto Rehabilitation Institute, 500 University Avenue, Toronto, Canada M5G 2A2.
11Scientist.
Tóm tắt
We considered whether a positive margin occurring after resection of a soft-tissue sarcoma of a limb would affect the incidence of local recurrence. Patients with low-grade liposarcomas were expected to be a low-risk group as were those who had positive margins planned before surgery to preserve critical structures. Two groups, however, were expected to be at a higher risk, namely, patients who had undergone unplanned excision elsewhere with a positive margin on re-excision and those with unplanned positive margins occurring during primary resection. Of 566 patients in a prospective database, 87 with positive margins after limb-sparing surgery and adjuvant radiotherapy were grouped according to the clinical scenario by an observer blinded to the outcome. The rate of local recurrence differed significantly between the two low- (4.2% and 3.6%) and the two high-risk groups (31.6% and 37.5%). This classification therefore provides useful information about the incidence of local recurrence after positive-margin resection.
