• Woo Young Jang, Han-Soo Kim, and Ilkyu Han.
• Department of Orthopaedic Surgery, Seoul National University Hospital.
• Medicine (Baltimore). 2021 Jan 22; 100 (3): e24124.

BackgroundThe impact of surgical margin status on the survival of patients with extremity soft tissue sarcoma (STS) remains to be clearly defined. The evidence regarding the impact of surgical margins on survival is limited by retrospective single-institution cohort studies. We conducted a systematic review and meta-analysis to examine the impact of surgical margin status on patient survival in extremity STS.MethodsA literature search in the PubMed, EMBASE, and Cochrane Controlled Trials Register electronic databases, and a manual search of reference lists of original studies was performed. The following text words and/or Medical Subject Heading terms were searched: (neoplasm) or/and (sarcoma) and/or (connective tissue) and/or (soft tissue) and/or (extremity) and/or (extremity) and/or (surgical margin).ResultsSix selected studies that reported a total of 2917 cases of extremity STS were published between 1994 and 2013. All the eligible studies were observational cohort studies, and the sample size ranged from 95 to 1261 patients. A meta-analysis of 6 studies showed that a positive surgical margin predicted poor 5-year OS in a random-effects model (summary hazard ratio, 1.56; 95% confidence interval, 1.12-2.17). Moderate heterogeneity was observed among the studies (P < .075; heterogeneity, 45.6%).ConclusionsThis meta-analysis supports the hypothesis that adequate surgical margins are associated with improved survival in extremity STS.Copyright © 2021 the Author(s). Published by Wolters Kluwer Health, Inc.

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