Effect of Surgical Margins on Local Recurrence Patterns of Myxofibrosarcomas: A Retrospective Cohort Study From the Stockholm Sarcoma Centre.

Introduction: One of the most common subgroups of soft tissue sarcomas are myxofibrosarcomas (MFS), which possess an infiltrative and aggressive growth pattern with a tendency for local recurrence (LR). MFS presents significant management challenges due to difficulties in achieving satisfactory surgical margins. The present study describes the LR pattern of MFS and its association with resection margin, re-excision surgery and adjuvant radiotherapy.

Method: This is a registry study conducted at the Sarcoma Centre at Karolinska University Hospital, Stockholm. All patients who underwent surgery with curative aim for MFS in this centre between 2010 and 2023 were included.

Results: LR was documented in 17/87 patients. Surgical margin was predictive of LR but not overall patient survival. The cumulative LR incidence at 3.5 years for intralesional, marginal, and wide margins were 80%, 40% and 10% respectively. RT was not shown to confer any suppressive effect on LR. Amputation was needed in five patients for local disease control.

Conclusion: Margins are the foremost determinants of LR for MFS. Proactive surgical management should be considered when margins are marginal.