King David M, Hackbarth Donald A, Kilian Chris M, Carrera Guillermo F
Department of Orthopaedic Surgery, Medical College of Wisconsin, Milwaukee, WI, 53226, USA.
Clin Orthop Relat Res. 2009 Nov;467(11):2838-44. doi: 10.1007/s11999-009-0989-1. Epub 2009 Jul 28.
The current standard of care for patients with extremity soft-tissue sarcomas is to obtain imaging of the chest for staging and surveillance. Our institutional standard of care has been to obtain CT scans of the chest, abdomen, and pelvis to evaluate for metastatic disease. Cost and radiation risk led us to question the utility of the additional scans. We presumed abdomen and pelvic CT scans would not benefit this patient population. We retrospectively reviewed our sarcoma databases from 2000 to 2008. We included 124 patients with 15 types of extremity soft tissue sarcomas evaluated with CT of the C/A/P. Primary outcomes were (1) location of metastatic disease in relation to (2) sarcoma type. Twenty patients (16%) presented with or developed abdomen/pelvis metastases and 10 of the 15 types of soft tissue sarcomas had abdominal or pelvic metastases. A larger number of patients demonstrated metastatic disease in the abdomen and pelvis than anticipated. We believe routine imaging of the abdomen and pelvic with CT for both staging and surveillance of all types of soft tissue sarcoma should be considered.
Level III, diagnostic study. See Guidelines for Authors for a complete description of levels of evidence.
目前，肢体软组织肉瘤患者的标准治疗方案是进行胸部影像学检查以进行分期和监测。我们机构的标准治疗方案是进行胸部、腹部和骨盆的CT扫描，以评估是否存在转移性疾病。成本和辐射风险使我们对额外扫描的实用性产生质疑。我们推测腹部和盆腔CT扫描对该患者群体并无益处。我们回顾性分析了2000年至2008年的肉瘤数据库。我们纳入了124例患有15种肢体软组织肉瘤的患者，这些患者均接受了胸部/腹部/骨盆CT检查。主要结果包括（1）转移性疾病的位置与（2）肉瘤类型的关系。20例患者（16%）出现或发生了腹部/盆腔转移，15种软组织肉瘤中有10种出现了腹部或盆腔转移。出现腹部和盆腔转移性疾病的患者数量比预期的要多。我们认为，对于所有类型的软组织肉瘤，应考虑常规进行腹部和盆腔CT成像以进行分期和监测。
III级，诊断性研究。有关证据水平的完整描述，请参阅作者指南。
