title: What is the role of routine follow-up for localised limb soft tissue sarcomas? A retrospective analysis of 174 patients.
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.
authors.affiliation: Division of Oncology/Haematology, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland.
authors.forename: C
authors.initials: C
authors.lastname: Rothermundt
authors.affiliation: London Sarcoma Service, University College London Hospitals, London NW1 2BU, UK.
authors.forename: J S
authors.initials: JS
authors.lastname: Whelan
authors.affiliation: London Sarcoma Service, University College London Hospitals, London NW1 2BU, UK.
authors.forename: P
authors.initials: P
authors.lastname: Dileo
authors.affiliation: London Sarcoma Service, University College London Hospitals, London NW1 2BU, UK.
authors.forename: S J
authors.initials: SJ
authors.lastname: Strauss
authors.affiliation: Department of Orthopaedic Surgery, Royal National Orthopaedic Hospital, Middlesex HA7 4LP, UK.
authors.forename: J
authors.initials: J
authors.lastname: Coleman
authors.affiliation: Department of Orthopaedic Surgery, Royal National Orthopaedic Hospital, Middlesex HA7 4LP, UK.
authors.forename: T W
authors.initials: TW
authors.lastname: Briggs
authors.affiliation: Clinical Trials Unit, Kantonsspital St. Gallen, 9007 St. Gallen, Switzerland.
authors.forename: S R
authors.initials: SR
authors.lastname: Haile
authors.affiliation: London Sarcoma Service, University College London Hospitals, London NW1 2BU, UK.
authors.forename: B M
authors.initials: BM
authors.lastname: Seddon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D017024:Chemotherapy, Adjuvant; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005121:Extremities / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053208:Kaplan-Meier Estimate; D008175:Lung Neoplasms / Q000000981:diagnostic imaging / Q000453:epidemiology / Q000556:secondary / Q000601:surgery; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D012509:Sarcoma / Q000453:epidemiology* / Q000556:secondary / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000453:epidemiology* / Q000628:therapy; D013997:Time Factors; D014057:Tomography, X-Ray Computed; D016896:Treatment Outcome; D055815:Young Adult
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