title: Follow-up after initial surgical treatment of soft tissue sarcomas in the extremities and trunk wall.
abstract: OBJECTIVE
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: a Musculoskeletal Tumor Section, Department of Orthopedic Surgery , Rigshospitalet, University of Copenhagen , Denmark.
authors.forename: Thea Bechmann
authors.initials: TB
authors.lastname: Hovgaard
authors.affiliation: b ITAR Section, Department of Orthopedic Surgery , Odense University Hospital, University of Southern Denmark , Odense , Denmark.
authors.forename: Tine
authors.initials: T
authors.lastname: Nymark
authors.affiliation: b ITAR Section, Department of Orthopedic Surgery , Odense University Hospital, University of Southern Denmark , Odense , Denmark.
authors.forename: Ole
authors.initials: O
authors.lastname: Skov
authors.affiliation: a Musculoskeletal Tumor Section, Department of Orthopedic Surgery , Rigshospitalet, University of Copenhagen , Denmark.
authors.forename: Michael Mørk
authors.initials: MM
authors.lastname: Petersen
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D005121:Extremities / Q000473:pathology* / Q000601:surgery; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008175:Lung Neoplasms / Q000556:secondary* / Q000601:surgery; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness; D009364:Neoplasm Recurrence, Local / Q000473:pathology* / Q000601:surgery; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000473:pathology* / Q000601:surgery; D015996:Survival Rate; D060726:Torso / Q000473:pathology* / Q000601:surgery; D055815:Young Adult