At the ISOLS Brisbane meeting in 2024 a session was held on margins in sarcoma surgery. This suggestion was suggested by Gerard Powell (Melbourne AUS) and our current President, Peter Steadman. The session was chaired by myself with Gerard Powell curating the questions and with a distinguished panel of experts. During that session we covered the history of margins, the importance of tissue types, how margins may be planned with radiology and importantly the lack of consistency in how they are described in research in the sarcoma space.
Part of the session was a vote of the attendees present to gain support for an ISOLS standardised approach to margins. This was almost unanimously passed in the voting. As such Peter Rose (Mayo USA) put out and expressions of interest and after a little delay we have put together an international group of experts from different fields to establish a framework, with the ultimate goal of presenting the framework to the group at the next ISOLS meeting in Austria.
The members of the group are as follows:
Andy Johnston (Orthopaedic Oncologist Auckland New Zealand)
Michael Parry (Orthopaedic Oncologist Birmingham UK)
Gerard Powell (Orthopaedic Oncologist Melbourne AUS)
Tom Hilton (Orthopaedic Oncologist Capetown SA)
Rodrigo Cardoso (Orthopaedic Oncologist Rio de Janeiro BRA)
Alexandra Callan (Orthopaedic Oncologist Texas USA)
Ben Millar (Orthopaedic Oncologist Iowa USA)
Keisuke Ae (Orthopaedic Oncologist Tokyo JPN)
Fernanda Amary (Sarcoma Pathologist London UK)
Daniel Baumhoer (Sarcoma Pathologist Basel CH)
Thomas Lloyd (Radiologist Brisbane Aus)
Rajesh Botchu (Radiologist Birmingham UK)
We have had our initial meeting at which both Rose and Steadman gave some context and thanked everyone for taking part in the group.
The group felt our main objective should be to come up with a recommended framework that all sarcoma research discussing margins would adhere to. To do this we have split into three groups with crossover amongst the groups: Pathology margins, radiological margins and surgical margins. Obviously to do this we need all reporting to be done in a similar fashion across the board. For example closest pathological margin documented in MM Rather than as “wide”. After these work streams are complete the complete group will convene again to discuss our final recommendation to take to ISOLS 2026.
Currently the subgroups are aiming to have the discussions initially complete by the end of October so another large group meeting can be held in November before the Christmas rush. We will also take advantage of the upcoming BOOM meeting in Cape Town to gather all members of the group who are attending to have a face to face discussion.