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Erschienen in: Clinical Orthopaedics and Related Research® 3/2014

01.03.2014 | Symposium: Musculoskeletal Tumor Society 2012 Symposium

How Long Should We Follow Patients With Soft Tissue Sarcomas?

verfasst von: Chigusa Sawamura, MD, MPH, Seiichi Matsumoto, MD, PhD, Takashi Shimoji, MD, PhD, Atsushi Okawa, MD, PhD, Keisuke Ae, MD, PhD

Erschienen in: Clinical Orthopaedics and Related Research® | Ausgabe 3/2014

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Abstract

Background

Guidelines suggest that followup for low-grade soft tissue sarcomas should be every 3 to 6 months for 2 to 3 years and then annually, and for high-grade sarcomas every 3 to 6 months for 2 to 5 years, then every 6 months for the next 2 years, and then annually. However, there is only very limited evidence to support these strategies.

Questions/purposes

In a population of patients treated surgically for soft tissue sarcomas, we evaluated the (1) timing of diagnosis of local recurrences after sarcoma excision; (2) timing of diagnosis of distant metastases; and (3) the difference in those parameters based on tumor size and grade.

Methods

Patients diagnosed with soft tissue sarcomas and who underwent surgical excision between 1978 and 2008 were retrospectively reviewed. Age, histologic diagnosis, Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade, tumor location, and size were reviewed at a mean of 6 years (range, 1 month to 30 years). We met with patients every 3 months for 5 years, every 6 months for 10 years, and then annually until 15 years after surgery. Eight hundred sixty-seven patients with a median age at diagnosis of 52 years were eligible for analysis. The incidence of local recurrence and metastases was calculated for every 2-year period and presented per 1000 person-years.

Results

Ninety-eight patients (11%) developed local recurrence at a median time of 19 months; 90% of patients who had local recurrences had them within 7.1 years, and 95% occurred by 8.6 years. One hundred ninety-eight patients (23%) developed distant metastases at a median time of 12 months; 90% of patients who developed metastases developed them by 4.2 years and 95% did so by 7.3 years. High-grade tumors had a higher incidence of local recurrence and metastases in first 2 years, whereas low-grade tumors recurred at a constant rate throughout the followup period.

Conclusions

Followup beyond 10 years does not yield a sufficient number of local recurrences or metastases to warrant further monitoring.

Level of Evidence

Level II, prognostic study. See Guidelines for Authors for a complete description of levels of evidence.
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Metadaten
Titel
How Long Should We Follow Patients With Soft Tissue Sarcomas?
verfasst von
Chigusa Sawamura, MD, MPH
Seiichi Matsumoto, MD, PhD
Takashi Shimoji, MD, PhD
Atsushi Okawa, MD, PhD
Keisuke Ae, MD, PhD
Publikationsdatum
01.03.2014
Verlag
Springer US
Erschienen in
Clinical Orthopaedics and Related Research® / Ausgabe 3/2014
Print ISSN: 0009-921X
Elektronische ISSN: 1528-1132
DOI
https://doi.org/10.1007/s11999-013-3076-6

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