The role of radiation therapy and margin width in localized soft-tissue sarcoma: Analysis from the US Sarcoma Collaborative

Nicholas P. Gannon, David M. King, Cecilia G. Ethun, John Charlson, Thuy B. Tran, George Poultsides, Valerie Grignol, J. Harrison Howard, Jennifer Tseng, Kevin K. Roggin, Konstantinos Votanopoulos, Bradley Krasnick, Ryan C. Fields, Kenneth Cardona, Meena Bedi

Research output: Contribution to journalArticlepeer-review

9 Scopus citations

Abstract

Background and Objectives: Soft-tissue sarcomas (STSs) are often treated with resection and radiation (RT)±chemotherapy. The role of RT in decreasing resection width to achieve local control is unclear. We evaluated RT on margin width to achieve local control and local recurrence (LR). Methods: From 2000 to 2016, 514 patients with localized STS were identified from the US Sarcoma Collaborative database. Patients were stratified by a margin and local control was compared amongst treatment groups. Results: LR was 9% with positive, 4.2% with ≤1 mm, and 9.3% with >1 mm margins (P =.315). In the ≤1 mm group, LR was 5.7% without RT, 0% with preoperative RT, and 0% with postoperative RT (P <.0001). In the >1 mm group, LR was 10.2%, 0%, and 3.7% in the no preoperative and postoperative RT groups, respectively (P =.005). RT did not influence LR in patients with positive margins. In stage I-III and II-III patients, local recurrence-free survival was higher following RT (P =.008 and P =.05, respectively). Conclusions: RT may play a larger role in minimizing LR than margin status. In patients with positive margins, RT may decrease LR to similar rates as a negative margin without RT and may be considered to decrease the risk of LR with anticipated close/positive margins.

Original languageEnglish
Pages (from-to)325-331
Number of pages7
JournalJournal of surgical oncology
Volume120
Issue number3
DOIs
StatePublished - Sep 2019

Keywords

  • preoperative chemotherapy
  • preoperative radiation
  • prognostic
  • resection
  • survival

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