Follow-up after primary treatment of soft tissue sarcoma of extremities: impact of frequency of follow-up imaging on disease-specific survival.
OBJECTIVE
We explored the impact of frequency of surveillance imaging on disease-specific survival (DSS) in patients with extremity soft tissue sarcoma (STS).


METHODS
Locoregional imaging (LRI) and chest imaging (CI) were used to detect local recurrence (LR) and distant metastasis (DM), respectively. Relapsing patients were retrospectively assigned to more frequent surveillance (MFS) or less frequent surveillance (LFS) groups, according to the median interval for each follow-up modality. Outcome measures included overall DSS (O-DSS), post-LR DSS, and post-DM DSS.


RESULTS
We assigned 165 patients to three distinct risk groups according to tumor size (≤5 vs. >5 cm), depth (superficial- vs. deep-seated), grade (I vs. II or III), and surgical margin (≥10 vs. <10 mm). Data for 80 patients who relapsed were analyzed. Among 50 high-risk (with all four risk factors) relapsing patients, those in the MFS group for either LRI or CI had better O-DSS (LRI, median 44.07 vs. 27.43 months, P = 0.008; CI, median 43.60 vs. 36.93 months, P = 0.036), post-LR DSS (median 27.20 vs. 10.63 months, P = 0.028) and post-DM DSS (median 13.20 vs. 6.24 months, P = 0.031).


CONCLUSIONS
More frequent follow-up were associated with improved survival in high-risk relapsing patients with extremity STS by providing greater opportunities for adequate reoperation.
Division of Hematology and Oncology, Department of Medicine, Taipei Veterans General Hospital, Taipei, Taiwan.
Yi-Sheng
YS
Chou
Chun-Yu
CY
Liu
Wei-Ming
WM
Chen
Tain-Hsiung
TH
Chen
Paul Chih-Hsueh
PC
Chen
Hung-Ta Hondar
HT
Wu
Hong-Jen
HJ
Chiou
Cheng-Ying
CY
Shiau
Yu-Chung
YC
Wu
Chien-Lin
CL
Liu
Ta-Chung
TC
Chao
Cheng-Hwai
CH
Tzeng
Chueh-Chuan
CC
Yen
D000368:Aged; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003952:Diagnostic Imaging / Q000379:methods*; D018572:Disease-Free Survival; D005121:Extremities / Q000473:pathology / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D051677:Histiocytoma, Malignant Fibrous / Q000401:mortality / Q000601:surgery; D006801:Humans; D007890:Leiomyosarcoma / Q000401:mortality / Q000601:surgery; D008080:Liposarcoma / Q000401:mortality / Q000601:surgery; D008297:Male; D008875:Middle Aged; D020360:Neoadjuvant Therapy / Q000379:methods; D060787:Neoplasm Grading; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis* / Q000517:prevention & control*; D009367:Neoplasm Staging; D011159:Population Surveillance / Q000379:methods*; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D012307:Risk Factors; D012509:Sarcoma / Q000401:mortality* / Q000473:pathology / Q000517:prevention & control* / Q000628:therapy; D013584:Sarcoma, Synovial / Q000401:mortality / Q000601:surgery; D012983:Soft Tissue Neoplasms / Q000401:mortality* / Q000473:pathology / Q000517:prevention & control* / Q000628:therapy; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome