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

Authors
 YONG BAE KIM  ;  KYU HO SHIN  ;  JINSIL SEONG  ;  JAE KYUNG ROH  ;  GWI EON KIM  ;  SOO BONG HAHN  ;  CHANG OK SUH 
Citation
 International Journal of Radiation Oncology Biology Physics, Vol.70(1) : 139-144, 2008 
Journal Title
 International Journal of Radiation Oncology Biology Physics 
ISSN
 0360-3016 
Issue Date
2008
MeSH
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Disease-Free Survival ; Extremities ; Female ; Humans ; Male ; Middle Aged ; Neoplasm, Residual ; Radiotherapy Dosage ; Radiotherapy, Adjuvant/adverse effects ; Regression Analysis ; Sarcoma/mortality ; Sarcoma/pathology* ; Sarcoma/radiotherapy* ; Sarcoma/surgery ; Soft Tissue Neoplasms/mortality ; Soft Tissue Neoplasms/pathology* ; Soft Tissue Neoplasms/radiotherapy* ; Soft Tissue Neoplasms/surgery ; Treatment Failure
Keywords
Adolescent ; Adult ; Aged ; Aged, 80 and over ; Child ; Disease-Free Survival ; Extremities ; Female ; Humans ; Male ; Middle Aged ; Neoplasm, Residual ; Radiotherapy Dosage ; Radiotherapy, Adjuvant/adverse effects ; Regression Analysis ; Sarcoma/mortality ; Sarcoma/pathology* ; Sarcoma/radiotherapy* ; Sarcoma/surgery ; Soft Tissue Neoplasms/mortality ; Soft Tissue Neoplasms/pathology* ; Soft Tissue Neoplasms/radiotherapy* ; Soft Tissue Neoplasms/surgery ; Treatment Failure
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.
Full Text
http://www.sciencedirect.com/science/article/pii/S0360301607010255
DOI
17919843
Appears in Collections:
1. College of Medicine (의과대학) > Dept. of Internal Medicine (내과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Orthopedic Surgery (정형외과학교실) > 1. Journal Papers
1. College of Medicine (의과대학) > Dept. of Radiation Oncology (방사선종양학교실) > 1. Journal Papers
Yonsei Authors
Kim, Gwi Eon(김귀언)
Kim, Yong Bae(김용배) ORCID logo https://orcid.org/0000-0001-7573-6862
Roh, Jae Kyung(노재경)
Suh, Chang Ok(서창옥)
Seong, Jin Sil(성진실) ORCID logo https://orcid.org/0000-0003-1794-5951
Shin, Kyoo Ho(신규호)
Hahn, Soo Bong(한수봉)
URI
https://ir.ymlib.yonsei.ac.kr/handle/22282913/107491
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