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What is the role of routine follow-up for localised limb soft tissue sarcomas? A retrospective analysis of 174 patients

Christian Rothermundt, J S Whelan, P Dileo, S J Strauss, J Coleman, T W Briggs, Sarah Haile & B M Seddon

abstract

BACKGROUND
There are neither prospective data nor agreement on the optimal routine follow-up procedures in patients treated for soft tissue sarcoma of the limb.

METHODS
Data on 174 consecutive patients with a soft tissue sarcoma of the limb undergoing follow-up by oncologists at a single centre from 2003 to 2009 were included in this analysis. The rate and site of recurrence and mode of detection were analysed. Outcome of the patients was assessed.

RESULTS
Eighty-two patients (47%) experienced relapse of any type. Isolated local recurrence occurred in 26 patients and local relapse with synchronous pulmonary metastases in five patients. Local recurrences were detected clinically in 30 of these 31 patients; magnetic resonance imaging identified only one local recurrence. Twenty-eight patients developed isolated lung metastases; in nine patients these were amenable to resections, seven of whom are currently free of disease after treatment. Lung metastases were detected by chest x-ray (CXR) in 19 patients, computed tomography scanning in 3 patients, and clinically in 11 patients. Twenty-three patients developed non-pulmonary metastases. More than 80% of relapses occurred in the first 2 years of follow-up; however, later recurrences were also observed.

CONCLUSIONS
Routine follow-up CXR can detect lung metastases suitable for surgical resection, although the optimal interval of imaging has yet to be defined. Local relapse is almost always detected by patients or physicians, and routine scanning of the primary site is of doubtful benefit. Patient and physician education to detect local relapse may be helpful. Prospective evaluation of follow-up is recommended.
   
citation Rothermundt C, Whelan J S, Dileo P, Strauss S J, Coleman J, Briggs T W, haile s, Seddon B M. What is the role of routine follow-up for localised limb soft tissue sarcomas? A retrospective analysis of 174 patients. Br J Cancer 2014; 110:2420-6.
   
type journal paper/review (English)
date of publishing 15-04-2014
journal title Br J Cancer (110/10)
ISSN electronic 1532-1827
pages 2420-6
PubMed 24736584
DOI 10.1038/bjc.2014.200