Clear surgical margins as a prognostic indicator for disease recurrence, with no impact on survival rates in patients with myxofibrosarcoma

• Published in: Scientific reports Vol. 14; no. 1; p. 12232
• Main Authors: Tomáš, Tomáš, Apostolopoulos, Vasileios, Pazourek, Lukáš, Kubíček, Marián, Staniczková Zambo, Iva, Adámková, Dagmar, Šlampa, Pavel, Mahdal, Michal
• Format: Journal Article
• Language: English
• Published: London Nature Publishing Group UK 28.05.2024; Nature Publishing Group; Nature Portfolio
• Subjects: 692/4028/546; 692/699/67/1798; Adult; Aged; Aged, 80 and over; Disease-Free Survival; Female; Fibrosarcoma - mortality; Fibrosarcoma - pathology; Fibrosarcoma - surgery; Growth patterns; Humanities and Social Sciences; Humans; Male; Margins of Excision; Medical prognosis; Metastases; Middle Aged; multidisciplinary; Neoplasm Recurrence, Local - pathology; Patients; Prognosis; Retrospective Studies; Science; Science (multidisciplinary); Survival; Survival Rate; Tumors
• ISSN: 2045-2322; 2045-2322
• DOI: 10.1038/s41598-024-63035-6

Myxofibrosarcoma presents an infiltrating growth pattern that results in a high tendency for local recurrence. Clear margin resection is challenging because of microscopic infiltration. The purpose of the present study was to analyze the overall and disease-free survival rates of patients with myxofibrosarcoma and the prognostic factors that determine both survival and disease recurrence. Among the 111 patients included in our study, the 5-year overall survival rate was 65.5%. An age of more than 65 years (hazard ratio [HR] 1.9 [95% confidence interval (CI) 1.4–5.6]; p < 0.001), a tumor size of more than 5 cm (HR 2.8 [95% CI 0.9–8.1]; p = 0.049) and the G3 tumor grade (HR 14.1 [95% CI 2.1–105.0]; p < 0.001) negatively affected overall survival. The 5-year recurrence-free survival rate was 49.4%. R1/R2-type resection (HR 2.4 [95% CI 1.0–5.6]; p = 0.048) had a detrimental effect on tumor recurrence. Clear margins had a positive impact on recurrence-free survival, but did not significantly affect overall patient survival, suggesting that other factors may play a more significant role in determining patient outcomes. A surgical margin of 2 mm was not sufficient to significantly influence the incidence of recurrence. Consequently, a wider surgical margin may be necessary to reduce the risk of myxofibrosarcoma recurrence.