DOI: 10.2106/jbjs.rvw.23.00224 ISSN: 2329-9185

Surgical Margins in Musculoskeletal Sarcoma

Julia C. Quirion, Samuel R. Johnson, Brooke L. Kowalski, Jennifer L. Halpern, Herbert S. Schwartz, Ginger E. Holt, Carlos Prieto-Granada, Reena Singh, Justin M.M. Cates, Brian P. Rubin, Nathan W. Mesko, Lukas M. Nystrom, Joshua M. Lawrenz
  • Orthopedics and Sports Medicine
  • Surgery

» Negative margin resection of musculoskeletal sarcomas is associated with reduced risk of local recurrence.

» There is limited evidence to support an absolute margin width of soft tissue or bone that correlates with reduced risk of local recurrence.

» Factors intrinsic to the tumor, including histologic subtype, grade, growth pattern and neurovascular involvement impact margin status and local recurrence, and should be considered when evaluating a patient's individual risk after positive margins.

» Appropriate use of adjuvant therapy, critical analysis of preoperative advanced cross-sectional imaging, and the involvement of a multidisciplinary team are essential to obtain negative margins when resecting sarcomas.

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