Follow-up after initial surgical treatment of soft tissue sarcomas in the extremities and trunk wall

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BACKGROUND/OBJECTIVES: Evaluation of our surveillance program for soft tissue sarcomas (STS) and borderline tumors (BT) for identification of local recurrence and lung metastases the first 2 years postoperatively.

METHODS: We retrospectively assessed the medical files of all patients (n = 232) with STS and BT of the extremities and trunk wall who underwent surgery from 2010 to 2013. Two-hundred-and-thirty-two patients were included in the local recurrence study and 116 patients in the lung metastasis study. We extracted information on how local recurrence and lung metastases were detected. Kaplan-Meier survival analysis and 2 × 2-contingency table with Chi-square test were used. Local recurrence and lung metastases were analyzed separately.

RESULTS: Twenty-five of 232 patients experienced local recurrence and 19 of 116 patients experienced lung metastases. Compared to clinical examination, local imaging led to a larger amount of local recurrence suspicions (37/560 vs. 8/706). Suspicions occurring on local imaging were more accurate than on clinical examination (17/37 vs. 0/8 affirmed). Local imaging identified a larger amount of local recurrence than clinical examination (17/560 vs. 0/706). Thirty-three patients suspected local recurrence themselves, 8 were affirmed. Compared to x-ray, computerized tomography (CT) led to a larger amount of lung metastasis suspicions (22/284 vs. 6/276). Suspicions occurring on CT seemed more accurate than on x-ray (15/22 vs. 2/6 affirmed). CT found a larger amount of lung metastases than x-ray (15/284 vs. 2/276). Three patients suspected lung metastases themselves, 1 was affirmed.

CONCLUSION: Bi-annual local imaging and CT the first 2 years after surgery of STS detect local recurrence and lung metastases better than clinical examination and x-ray. Clinical examination and x-ray between these examinations is unnecessary. Patients' own suspicion of local recurrence and lung metastases is still important.

Original languageEnglish
JournalActa Oncologica
Volume56
Issue number7
Pages (from-to)1004-1012
ISSN0284-186X
DOIs
Publication statusPublished - 2017

    Research areas

  • Adolescent, Adult, Aged, Aged, 80 and over, Extremities/pathology, Female, Follow-Up Studies, Humans, Lung Neoplasms/secondary, Lymphatic Metastasis, Male, Middle Aged, Neoplasm Invasiveness, Neoplasm Recurrence, Local/pathology, Prognosis, Retrospective Studies, Sarcoma/pathology, Survival Rate, Torso/pathology, Young Adult

ID: 193959061