Surgical margin distance and oncological outcomes in extremity soft tissue sarcomas: a retrospective study

The prognostic significance of surgical margin distance in extremity soft tissue sarcomas remains controversial. This study aimed to investigate the effect of surgical margin distance on local recurrence, metastasis, and mortality in patients with soft tissue sarcoma. Patients diagnosed with soft tissue sarcoma who underwent surgical treatment between 2016 and 2020 at a single tertiary referral institution were retrospectively evaluated. Tumor staging was performed according to the American Joint Committee on Cancer (AJCC) staging system. Surgical margins were classified as ≤ 1 mm and > 1 mm. Demographic characteristics, tumor features, treatment modalities, local recurrence, metastasis, and mortality were analyzed. A total of 60 patients were included in the study. The mean age was 49.07 ± 21.61 years. Synovial sarcoma was the most common histopathological subtype (30.0%). According to AJCC staging, stage 3B was the most frequent stage (28.3%), followed by stage 4 disease (21.7%). Negative surgical margins > 1 mm were achieved in 81.7% of patients, whereas 18.3% had margins ≤ 1 mm. No significant differences were observed between the ≤ 1 mm and > 1 mm margin groups in terms of local recurrence, metastasis, or mortality ( p > 0.05). Advanced AJCC stage was significantly associated with worse clinical outcomes. Surgical margin distance did not significantly affect local recurrence, metastasis, or mortality in patients with soft tissue sarcoma when negative surgical margins were achieved. Tumor biology and disease stage appear to play a more important role in determining prognosis than absolute margin distance.