Image intensive soft tissue sarcoma surveillance uncovers pathology earlier than patient complaints but with frequent initially indeterminate lesions.

INTRODUCTION

Post-treatment surveillance follow-up soft-tissue sarcomas is controversial. Protocols are highly variable. This study retrospectively evaluates an image intense protocol to assess benefits of identifying true pathology compared to incidental findings.

METHODS

A retrospective chart review was conducted on a single orthopedic oncologist's soft tissue sarcoma patients under a consistent protocol (TAD). Study population included patients who underwent resection of non-metastatic soft tissue sarcoma (AJCC stages I-III) and either died within surveillance period or completed 5 years of follow-up.

RESULTS

Thirty-nine patients met the strict study criteria. 24/39 (61.5%) patients were identified to have a local recurrence (6), chest metastasis (6), isolated distant recurrence (9), or new primary tumor (3). Of those 24 patients with true pathology, 13 (54%) or 33% (13/39) of all patients potentially benefited from discovery via imaging before patient complaint. Chest CT was the first to reveal all lung metastases. For balance, 32/39 (82%) patients had at least 1 initially "indeterminate" lesion on imaging. Of those, 91% (29/32)-74% of all patients (29/39)-proved to be inconsequential by final follow up.

CONCLUSION

Of the true pathology identified, over half were not evident on clinical presentation, emphasizing the importance of a routine surveillance. However, an image intense surveillance program has a high rate of initially indeterminate findings. J. Surg. Oncol. 2016;113:818-822. © 2016 Wiley Periodicals, Inc.