Cutting Away More Healthy Tissue Might Not Meaningfully Reduce Future Cancer Risk

WEDNESDAY, Nov. 4, 2026 (HealthDay News) — Doctors removing cancers surgically might not need to cut away lots of healthy tissue to make sure they’ve gotten all the tumor, a new study says.

For one form of childhood cancer, the chances it might come back can be lowered with less healthy tissue removal than previously thought, researchers reported recently in JAMA Surgery.

Close surgical margins as small as a millimeter — less than one-tenth the traditional margin — maintain a low risk of recurrence while sparing precious healthy tissue in cases of childhood soft tissue sarcoma, researchers found.

“For a child, a few millimeters can make a lifelong difference when a tumor is next to an important nerve or blood vessel,” said senior researcher Dr. R. Lor Randall, an orthopedic surgeon at the University of California-Davis.

“For the first time, we have evidence from a large prospective trial to help answer how closely we can safely get to these tumors,” Randall said in a news release. “It is very exciting to find that getting close to the tumor — within a millimeter — can potentially save a blood vessel or healthy tissue and meet the standard of care, something that had never been shown before.”

Surgical margins are the surrounding healthy tissue taken out during cancer surgery to ensure that all of a tumor has been removed.

For this study, researchers focused on 266 children who underwent surgery for non-rhabdomyosarcoma soft tissue sarcomas (NRSTS) — a group of cancers that start in tissues that normally develop into muscles, nerves and tissues.

NRSTS account for more than half of soft tissue sarcomas in children and young adults, researchers said in background notes. Every year, about 550 new cases are diagnosed among U.S. kids.

Standard treatment for NRSTS is surgery to fully remove the tumor, with no cancer cells detectable at the microscopic edges of the removed cancer. This is called a negative, or cancer-free, margin.

Traditionally, protocol calls for a 1-to-2-centimeter margin when feasible, but that can mean a lot of healthy tissue — nerves, blood vessels, tendons, joints — taken out of the smaller bodies of children, researchers said.

“When we remove a tumor, our goal is to leave no cancer behind,” Randall said. “So, when we operate on a child or young adult with soft tissue sarcomas, we ask how surgically aggressive we need to be in obtaining this negative margin?”

Among the children in the study, 178 received surgery alone and 88 also received chemo and radiation therapy. Their median age was just under 14 years old. (Median means half were younger; half were older.)

Researchers reviewed medical records for all the children and followed their progress for a median of just over six years.

Results showed that risk of cancer returning at the surgical site was 4.9% for a 1-millimeter margin; 2% for a 2-to-5-millimeter margin; and 0% for a margin of 6 millimeters or more.

Smaller tumors do well with close margins even without chemo or radiation, but larger tumors likely require that additional treatment, Randall said.

The risk of cancer return was under 6% for children with smaller tumors who didn’t get any chemo or radiation therapy.

For kids with large tumors who got chemo, the risk of recurrence was 3.7%.

“These findings can help surgeons decide when a close, but cancer-free margin may be enough, allowing them to preserve more of a young person’s limb and its function,” researcher Dr. Sheri Spunt, a former professor of pediatric cancer at Stanford University who is now a senior medical director at AbbVie, said in a news release.

Randall noted that these cancers are rare, and that decisions about surgical margins will require a team experienced in treating them.

“Children with these rare cancers should be cared for at centers with extensive experience treating pediatric sarcoma,” Randall said. “They need access to pediatric oncologists, radiation therapists and surgeons who meet regularly to plan their care.”

More information

The National Cancer Institute has more on childhood soft tissue sarcoma.

SOURCE: University of California-Davis, news release, Oct. 28, 2026