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Classification of positive margins after resection of soft-tissue sarcoma of the limb predicts the risk of local recurrence

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² Department of Pathology, 6th Floor, Mount Sinai Hospital, 600 University Avenue, Toronto, Canada M5G 1X5.
³ Department of Radiation Oncology, Princess Margaret Hospital, the University Health Network, 5th floor, 610 University Avenue, Toronto, Canada M56 2M9.
⁴ Room 1119, Toronto Rehabilitation Institute, 500 University Avenue, Toronto, Canada M5G 2A2.

Correspondence should be sent to Dr A. M. Davis.

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.

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