Clinical Significance of Margin Status in Postoperative Radiotherapy for Extremity and Truncal Soft-Tissue Sarcoma

Yong Bae Kim, Kyu Ho Shin, Jinsil Seong, Jae Kyung Roh, Gwi Eon Kim, Soo Bong Hahn, Chang Ok Suh

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Abstract

Purpose: To evaluate whether adjuvant radiotherapy (RT) in extremity and truncal soft-tissue sarcoma (STS) patients with microscopically positive or close margins after excision can achieve comparable local control to that of excision with negative margin plus RT. Methods and Materials: A total of 150 patients (111 extremity and 39 trunk cases) treated with conserving surgery and adjuvant RT was analyzed. All surgical margins were classified as being a negative margin or a positive or close margin based on pathologic margin width. RT was delivered with a shrinking-field technique in 150 patients (median, 63 Gy). Results: All patients were divided into two groups: (A) excision with negative margins plus RT (n = 56) and (B) excision with positive or close margins plus RT (n = 94). Overall, the 5-year local failure-free survival in all patients was 72.9%, and no significant differences were found between the two groups (Group A, 74.7%; Group B, 71.6%). High tumor grade was found to be a significant predictor of local failure. However, Group A was superior to Group B in distant metastasis-free survival (p = 0.02). No significant differences were shown in overall survival between the two groups. Conclusions: In our series, margin status did not predict for LF when adjuvant RT was used. We believe that when adjuvant RT is used, re-resection may not be necessary for selected patients with positive or close pathologic margins in the management of extremity and truncal STS patients.

Original languageEnglish
Pages (from-to)139-144
Number of pages6
JournalInternational Journal of Radiation Oncology Biology Physics
Volume70
Issue number1
DOIs
Publication statusPublished - 2008 Jan 1

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Sarcoma
radiation therapy
margins
Radiotherapy
Extremities
cancer
Adjuvant Radiotherapy
Survival
metastasis
Neoplasm Metastasis
surgery
grade
tumors
Neoplasms
predictions

All Science Journal Classification (ASJC) codes

  • Radiation
  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Cancer Research

Cite this

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title = "Clinical Significance of Margin Status in Postoperative Radiotherapy for Extremity and Truncal Soft-Tissue Sarcoma",
abstract = "Purpose: To evaluate whether adjuvant radiotherapy (RT) in extremity and truncal soft-tissue sarcoma (STS) patients with microscopically positive or close margins after excision can achieve comparable local control to that of excision with negative margin plus RT. Methods and Materials: A total of 150 patients (111 extremity and 39 trunk cases) treated with conserving surgery and adjuvant RT was analyzed. All surgical margins were classified as being a negative margin or a positive or close margin based on pathologic margin width. RT was delivered with a shrinking-field technique in 150 patients (median, 63 Gy). Results: All patients were divided into two groups: (A) excision with negative margins plus RT (n = 56) and (B) excision with positive or close margins plus RT (n = 94). Overall, the 5-year local failure-free survival in all patients was 72.9{\%}, and no significant differences were found between the two groups (Group A, 74.7{\%}; Group B, 71.6{\%}). High tumor grade was found to be a significant predictor of local failure. However, Group A was superior to Group B in distant metastasis-free survival (p = 0.02). No significant differences were shown in overall survival between the two groups. Conclusions: In our series, margin status did not predict for LF when adjuvant RT was used. We believe that when adjuvant RT is used, re-resection may not be necessary for selected patients with positive or close pathologic margins in the management of extremity and truncal STS patients.",
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Clinical Significance of Margin Status in Postoperative Radiotherapy for Extremity and Truncal Soft-Tissue Sarcoma. / Kim, Yong Bae; Shin, Kyu Ho; Seong, Jinsil; Roh, Jae Kyung; Kim, Gwi Eon; Hahn, Soo Bong; Suh, Chang Ok.

In: International Journal of Radiation Oncology Biology Physics, Vol. 70, No. 1, 01.01.2008, p. 139-144.

Research output: Contribution to journalArticle

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AU - Kim, Gwi Eon

AU - Hahn, Soo Bong

AU - Suh, Chang Ok

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N2 - Purpose: To evaluate whether adjuvant radiotherapy (RT) in extremity and truncal soft-tissue sarcoma (STS) patients with microscopically positive or close margins after excision can achieve comparable local control to that of excision with negative margin plus RT. Methods and Materials: A total of 150 patients (111 extremity and 39 trunk cases) treated with conserving surgery and adjuvant RT was analyzed. All surgical margins were classified as being a negative margin or a positive or close margin based on pathologic margin width. RT was delivered with a shrinking-field technique in 150 patients (median, 63 Gy). Results: All patients were divided into two groups: (A) excision with negative margins plus RT (n = 56) and (B) excision with positive or close margins plus RT (n = 94). Overall, the 5-year local failure-free survival in all patients was 72.9%, and no significant differences were found between the two groups (Group A, 74.7%; Group B, 71.6%). High tumor grade was found to be a significant predictor of local failure. However, Group A was superior to Group B in distant metastasis-free survival (p = 0.02). No significant differences were shown in overall survival between the two groups. Conclusions: In our series, margin status did not predict for LF when adjuvant RT was used. We believe that when adjuvant RT is used, re-resection may not be necessary for selected patients with positive or close pathologic margins in the management of extremity and truncal STS patients.

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