Multicenter prospective study of surgical margin and risk of local recurrence in children and young adults with nonrhabdomysarcoma STS

The extent of negative margin necessary to achieve a high rate of local tumor control in children and young adult patients with nonrhabdomyosarcoma soft tissue sarcomas (NRSTS) is unknown. A multicenter prospective clinical trial at Children’s Oncology Group member sites evaluated the impact of negative margin extent on local tumor control in these patients. Participants were 266 individuals younger that 30 years with nonmetastatic NRSTS who underwent R0 tumor resection withor without radiation therapy with or without ifosfamide/doxorubicin chemotherapy. The median follow-up was 6.2 years. Local recurrence was more common after surgery alone (5.6%) than after surgery and chemoradiotherapy (2.3%) and correlated with the extent of negative margins. Subgroup analysis showed low local recurrence among patients with tumor smaller than 5 cm treated with surgery alone with negative but narrow margins, and among patients with larger tumors treated with adjuvant chemotherapy or neoadjuvant chemoradiotherapy. The authors conclude that in this study, among children and young adults with NRSTS receiving risk-adapted treatment, negative but narrow surgical margins were associated with low local recurrence rates after R0 resection.