Surgical Margins in Sarcoma
Dr. Raphael Pollock: When a surgeon is attempting to extirpate a sarcoma in the operating room, margins become an issue of some importance. I say "some importance" because obviously there is much controversy about the nature of margins. Our attempt is to be operating through normal tissue at all time, but of course we're constrained by normal anatomy, anatomy that we can't safely remove, or anatomy that if we remove the patient's quality of life will be so severely compromised that the cure is almost worse than the cause.
Having said that, it is also true that a negative-margin resection, meaning at the edge of what was removed there are no cancer cells, does not guarantee that the patient will have a recurrence-free survival. By the same token, a microscopically positive margin does not doom a patient to recurrence. And in fact only a minority of patients with microscopically positive margins will ultimately develop a tumor recurrence in the future.