Evidence map›Paper›PMID 33150594›Full record

ArticleJournal of surgical oncology2021

Impact of resection margin on outcomes in high-grade soft tissue sarcomas of the extremity-A USSC analysis.

Konstantinos Chouliaras, Nathan Patel, Rebecca Senehi, Cecilia G Ethun, George Poultsides, Valerie Grignol, Thomas Clark Gamblin, Kevin K Roggin, Ryan C Fields, Ralph D'Agostino and 3 more

Open access · greenAbstract read
In one paragraph

Article in Journal of surgical oncology, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
0.4field-weighted citation impact, top 33% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed, 9 citations in OpenAlex.

  1. [Impact of unplanned surgery on prognosis of myxoid liposarcoma and analysis of salvage treatment strategies].Zhongguo xiu fu chong jian wai ke za zhi = Zhongguo xiufu chongjian waike zazhi = Chinese journal of reparative and reconstructive surgery · 2026
    Article
  2. Article
  3. Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

13 authors at 7 institutions in 1 country.

Konstantinos ChouliarasDepartment of Surgery, Wake Forest University, Winston-Salem, North Carolina, USA.ORCID http://orcid.org/0000-0002-6331-327X
Nathan PatelDepartment of Surgery, Wake Forest University, Winston-Salem, North Carolina, USA.
Rebecca SenehiDepartment of Surgery, Wake Forest University, Winston-Salem, North Carolina, USA.
Cecilia G EthunDepartment of Surgery, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.
George PoultsidesDepartment of Surgery, Stanford University, Palo Alto, California, USA.
Valerie GrignolDepartment of Surgery, The Ohio State University, Columbus, Ohio, USA.
Thomas Clark GamblinDepartment of Surgery, Medical College of Wisconsin, Milwaukee, Wisconsin, USA.ORCID http://orcid.org/0000-0001-7580-9961
Kevin K RogginDepartment of Surgery, University of Chicago Medicine, Chicago, Illinois, USA.
Ryan C FieldsDepartment of Surgery, Washington University, St. Louis, Missouri, USA.
Ralph D'AgostinoDepartment of Biostatistical Sciences, Wake Forest University, Winston-Salem, North Carolina, USA.
Edward A LevineDepartment of Surgery, Wake Forest University, Winston-Salem, North Carolina, USA.
Kenneth CardonaDepartment of Surgery, Winship Cancer Institute, Emory University, Atlanta, Georgia, USA.ORCID http://orcid.org/0000-0002-8200-3269
Konstantinos VotanopoulosDepartment of Surgery, Wake Forest University, Winston-Salem, North Carolina, USA.
Wake Forest University · USEmory University · USMedical College of Wisconsin · USPalo Alto University · USThe Ohio State University · USUniversity of Chicago · USWashington University in St. Louis · US

Funding

Tumor Tissue CoreP30CA012197 · NCI · WAKE FOREST UNIVERSITY HEALTH SCIENCES · PI Ruben A. Mesa · 1985 to 2026
$55.4M
NCI NIH HHS P30 CA012197
6 · The paper itself

Abstract

backgroundThe optimal margin of resection for high-grade extremity sarcomas and its impact on survival has long been questioned in the setting of adjuvant radiotherapy. The objective of this study was to investigate the impact of resection status on recurrence and survival.

methodsAll patients with primary, nonmetastatic, high-grade extremity sarcomas that underwent surgical resection from January 2000 to April 2016 in the U.S. Sarcoma Collaborative (USSC) were retrospectively reviewed. Recurrence patterns, recurrence-free survival (RFS), and overall survival (OS) were examined in multivariate analyses (MVA).

resultsA cohort of 959 patients was identified with a median follow-up of 34.7 months from diagnosis. R0 resection was achieved in 86.7% (831) while R1 resection in 13.3% (128). Locoregional recurrence for R0 and R1 groups occurred in 9.1% (76) versus 14.8% (19; p = .05) while distant recurrence occurred in 24.7% (205) versus 26.6% (34; p = .65), respectively. Median RFS was 171.2 versus 48.5 (p = .01) while median OS was 149.8 versus 71.5 months (p = .02) for the R0 versus R1 group, respectively. On MVA, female gender (hazard ratio [HR] = 0.69, p = .007) and adjuvant radiotherapy (0.7, p = .04) were associated with improved OS, whereas older age (HR = 1.03, p < .001) and tumor size (HR = 1.01, p < .001) were associated with worse OS. R0 resection status was associated with improved locoregional RFS (HR = 0.56, p = .03) but not with distant RFS (HR = 0.84, p = .4) or OS (HR = 0.7, p = .052).

conclusionsIn high-grade extremity sarcomas, tumor size and gender are predictive of OS while R0 resection status is associated with improved locoregional recurrence rate without a significant impact on distant RFS or OS.

Indexed as

Margins of ExcisionAgedExtremitiesFemaleFollow-Up StudiesHumansMaleMiddle AgedNeoplasm GradingNeoplasm Recurrence, LocalRetrospective StudiesSarcomaSurvival Ratehigh-grade extremity sarcomasnegative marginspredictors of recurrenceR resection status

Identifiers

PMID33150594
PMCPMC9716343
OpenAlexW3096062832

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.