Defining Surgical Margins in Nonrhabdomyosarcoma Soft Tissue Sarcoma
Mené sur 266 enfants ou jeunes adultes atteints d'un sarcome des tissus mous autre qu'un rhabdomyosarcome et ayant reçu un traitement multimodal adapté au risque comportant une résection R0 (durée de suivi médiane : 6,2 ans ; âge médian : 13,7 ans ; 52 % de filles), cet essai multicentrique évalue l'effet, sur le risque de récidive locale, de l’étendue des marges saines
For pediatric solid tumors and sarcomas, one of the primary challenges for surgeons is to remove the tumors with adequate oncologic margins without injury to surrounding critical structures. This task can be difficult to impossible with the smaller and limited space in children. In the current article, Hiniker and colleagues use prospectively collected data from Children’s Oncology Group (COG) study ARST0332 to address this challenging issue in children and young adults with nonrhabdomyosarcoma soft-tissue sarcoma (NRSTS).Among 266 patients with nonmetastatic NRSTS who underwent R0 resection, the 5-year cumulative incidence of local recurrence was 4.4%. Among the 132 patients with measurable margins, local recurrence was 4.9% with a 1-mm margin, 2.0% with margins of 2 to 5 mm, and 0% with margins of 6 mm or larger. These findings are reassuring and support a broader evolution in pediatric sarcoma care toward risk-adapted treatment and avoidance of unnecessary local morbidity.
JAMA Surgery , commentaire, 2026