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Utility of surgical margins in the radiotherapeutic management of soft tissue sarcomas
Author(s) -
Avizonis Vilija N.,
Sause William T.,
Menlove Ronald L.
Publication year - 1990
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.2930450206
Subject(s) - medicine , soft tissue , radiation therapy , sarcoma , surgery , soft tissue sarcoma , surgical margin , primary tumor , stage (stratigraphy) , radiology , metastasis , cancer , resection , pathology , paleontology , biology
Seventy‐four adult patients with localized soft tissue sarcomas were treated with radiation therapy following surgery between 1965 and 1988. Fiftythree were treated after the first excision of their tumor with 6 (11.3%) local recurrences. Twenty‐one received radiation after excision of recurrent disease with 11 (52.4%) local failures ( P <.0005). Metastatic disease occurred in 14 (26.4%) of the primary tumors and 8 (38.1%) with multiple previous excisions ( P <.48). Of those patients treated for primary sarcoma, there were no local failures with pathologically wide margins or if a single margin was microscopically positive. Local failure occurred in 4 of 26 (15.4%) if the tumor was merely enucleated and in 2 of 11 (18.2%) who had grossly positive surgical margins ( P not significant). Local failure was also more common in truncal locations (33.3%) as compared with extremity locations (8.7%, P =.1359). Additional factors analyzed which adversely affected prognosis included tumor grade, stage, and inadequate radiation dose.