Principles of Surgical Resection & Margins
Tumour resection aims to achieve oncologic control while preserving function; margin status is critical for local recurrence risk.
The goal of oncologic resection is complete tumour removal with appropriate margins to minimise recurrence.🔸 Surgical Margins (Enneking Classification):
Intralesional: Through the tumour — used in palliative or diagnostic settings.
Marginal: Through reactive zone — risk of microscopic disease.
Wide: Includes healthy cuff of tissue around tumour — standard for primary malignancies.
Radical: Entire compartment removed — used in selected sarcomas.🔸 Key Considerations:
Pre-operative planning with imaging is essential.
Biopsy tract must be included in resection.
Margins should be assessed intraoperatively and histopathologically.
Achieving a wide margin is often the best predictor of local control in malignant tumours.Balancing oncologic safety with preservation of function (e.g., limb salvage vs amputation) is central to surgical decision-making.
