A retrospective analysis was done of the rates of local recurrence in
eighty-one patients in whom soft-tissue sarcomas in the extremities and the
trunk were treated by surgery only. The minimum length of follow-up was six
years or until death. The surgical margin was wide in all patients
according to the definition of the surgical staging system of Enneking et
al., but we defined three types of wide margin. None of them included a
whole anatomical compartment, so that the radical resection, as defined by
the surgical staging system, was excluded from the study. The crude rates
of local recurrence in the three subgroups that were studied differed
significantly. There was no correlation between the rate of local
recurrence and the histological grade of malignancy. Our findings suggest
that the subclassification of the wide margin that we have applied to the
surgical staging system of Enneking et al. is of value. The low rates of
recurrence (less than 10 per cent) for subcutaneous lesions, and
intramuscular lesions that were treated by primary myectomy, were
comparable with those of radical resections and usually were followed by
minor loss of function. The higher rate of recurrence (30 per cent) for the
third subgroup, which included deep tumors that were not treated by
myectomy, was comparable with the rates found in other studies.