Designing a Rational Follow-Up Schedule for Patients with Extremity Soft Tissue Sarcoma

Purpose The risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to determine the frequency/timing of metastasis and local recurrence following treatment for soft tissue sarcoma, and to use these data to justify...

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Vydané v:	Annals of surgical oncology Ročník 27; číslo 6; s. 2033 - 2041
Hlavní autori:	Wilson, David A. J., Gazendam, Aaron, Visgauss, Julia, Perrin, David, Griffin, Anthony M., Chung, Peter W., Catton, Charles N., Shultz, David, Ferguson, Peter C., Wunder, Jay S.
Médium:	Journal Article
Jazyk:	English
Vydavateľské údaje:	Cham Springer International Publishing 01.06.2020 Springer Nature B.V
Predmet:	Adult Aged Diagnostic Imaging Disease Progression Disease-Free Survival Evidence-Based Medicine Extremities - pathology Extremities - surgery Female Follow-Up Studies Humans Incidence Kaplan-Meier Estimate Male Medicine Medicine & Public Health Metastases Metastasis Middle Aged Neoplasm Grading Neoplasm Metastasis - diagnosis Neoplasm Recurrence, Local - diagnosis Oncology Predictive Value of Tests Retrospective Studies Sarcoma Sarcoma - diagnostic imaging Sarcoma - pathology Sarcoma - surgery Soft tissue sarcoma Surgery Surgical Oncology Time Factors Tumors
ISSN:	1068-9265, 1534-4681, 1534-4681
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Abstract	Purpose The risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to determine the frequency/timing of metastasis and local recurrence following treatment for soft tissue sarcoma, and to use these data to justify an evidence-based follow-up schedule. Methods Utilizing a prospective database, a retrospective single center review was performed of all patients with minimum 2-year follow-up after resection of a localized extremity STS. Kaplan–Meier estimates were used to calculate the incidence of local recurrence and metastases on an annual basis for 10 years. Results We identified a total of 230 low-grade, 626 intermediate-grade and 940 high-grade extremity STS and a total of 721 events, 150 local recurrences and 571 metastases. Based on tumor size and grade, follow-up cohorts were developed that had similar metastatic risk. Using pre-determined thresholds for metastatic event, a follow-up schedule was established for each cohort. Conclusion Based on our results we recommend that patients with small low-grade tumors undergo annual follow-up for 5 years following definitive local treatment. Patients with large low-grade tumors, small intermediate-grade and small high-grade tumors should have follow-up every 6 months for the first 2 years, then yearly to 10 years. Only patients with large intermediate- or high-grade tumors require follow-up every 3 months for the first 2 years, then every 6 months for years 3–5, followed by annually until 10 years.
AbstractList	PurposeThe risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to determine the frequency/timing of metastasis and local recurrence following treatment for soft tissue sarcoma, and to use these data to justify an evidence-based follow-up schedule.MethodsUtilizing a prospective database, a retrospective single center review was performed of all patients with minimum 2-year follow-up after resection of a localized extremity STS. Kaplan–Meier estimates were used to calculate the incidence of local recurrence and metastases on an annual basis for 10 years.ResultsWe identified a total of 230 low-grade, 626 intermediate-grade and 940 high-grade extremity STS and a total of 721 events, 150 local recurrences and 571 metastases. Based on tumor size and grade, follow-up cohorts were developed that had similar metastatic risk. Using pre-determined thresholds for metastatic event, a follow-up schedule was established for each cohort.ConclusionBased on our results we recommend that patients with small low-grade tumors undergo annual follow-up for 5 years following definitive local treatment. Patients with large low-grade tumors, small intermediate-grade and small high-grade tumors should have follow-up every 6 months for the first 2 years, then yearly to 10 years. Only patients with large intermediate- or high-grade tumors require follow-up every 3 months for the first 2 years, then every 6 months for years 3–5, followed by annually until 10 years. The risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to determine the frequency/timing of metastasis and local recurrence following treatment for soft tissue sarcoma, and to use these data to justify an evidence-based follow-up schedule.PURPOSEThe risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to determine the frequency/timing of metastasis and local recurrence following treatment for soft tissue sarcoma, and to use these data to justify an evidence-based follow-up schedule.Utilizing a prospective database, a retrospective single center review was performed of all patients with minimum 2-year follow-up after resection of a localized extremity STS. Kaplan-Meier estimates were used to calculate the incidence of local recurrence and metastases on an annual basis for 10 years.METHODSUtilizing a prospective database, a retrospective single center review was performed of all patients with minimum 2-year follow-up after resection of a localized extremity STS. Kaplan-Meier estimates were used to calculate the incidence of local recurrence and metastases on an annual basis for 10 years.We identified a total of 230 low-grade, 626 intermediate-grade and 940 high-grade extremity STS and a total of 721 events, 150 local recurrences and 571 metastases. Based on tumor size and grade, follow-up cohorts were developed that had similar metastatic risk. Using pre-determined thresholds for metastatic event, a follow-up schedule was established for each cohort.RESULTSWe identified a total of 230 low-grade, 626 intermediate-grade and 940 high-grade extremity STS and a total of 721 events, 150 local recurrences and 571 metastases. Based on tumor size and grade, follow-up cohorts were developed that had similar metastatic risk. Using pre-determined thresholds for metastatic event, a follow-up schedule was established for each cohort.Based on our results we recommend that patients with small low-grade tumors undergo annual follow-up for 5 years following definitive local treatment. Patients with large low-grade tumors, small intermediate-grade and small high-grade tumors should have follow-up every 6 months for the first 2 years, then yearly to 10 years. Only patients with large intermediate- or high-grade tumors require follow-up every 3 months for the first 2 years, then every 6 months for years 3-5, followed by annually until 10 years.CONCLUSIONBased on our results we recommend that patients with small low-grade tumors undergo annual follow-up for 5 years following definitive local treatment. Patients with large low-grade tumors, small intermediate-grade and small high-grade tumors should have follow-up every 6 months for the first 2 years, then yearly to 10 years. Only patients with large intermediate- or high-grade tumors require follow-up every 3 months for the first 2 years, then every 6 months for years 3-5, followed by annually until 10 years. Purpose The risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to determine the frequency/timing of metastasis and local recurrence following treatment for soft tissue sarcoma, and to use these data to justify an evidence-based follow-up schedule. Methods Utilizing a prospective database, a retrospective single center review was performed of all patients with minimum 2-year follow-up after resection of a localized extremity STS. Kaplan–Meier estimates were used to calculate the incidence of local recurrence and metastases on an annual basis for 10 years. Results We identified a total of 230 low-grade, 626 intermediate-grade and 940 high-grade extremity STS and a total of 721 events, 150 local recurrences and 571 metastases. Based on tumor size and grade, follow-up cohorts were developed that had similar metastatic risk. Using pre-determined thresholds for metastatic event, a follow-up schedule was established for each cohort. Conclusion Based on our results we recommend that patients with small low-grade tumors undergo annual follow-up for 5 years following definitive local treatment. Patients with large low-grade tumors, small intermediate-grade and small high-grade tumors should have follow-up every 6 months for the first 2 years, then yearly to 10 years. Only patients with large intermediate- or high-grade tumors require follow-up every 3 months for the first 2 years, then every 6 months for years 3–5, followed by annually until 10 years. The risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to determine the frequency/timing of metastasis and local recurrence following treatment for soft tissue sarcoma, and to use these data to justify an evidence-based follow-up schedule. Utilizing a prospective database, a retrospective single center review was performed of all patients with minimum 2-year follow-up after resection of a localized extremity STS. Kaplan-Meier estimates were used to calculate the incidence of local recurrence and metastases on an annual basis for 10 years. We identified a total of 230 low-grade, 626 intermediate-grade and 940 high-grade extremity STS and a total of 721 events, 150 local recurrences and 571 metastases. Based on tumor size and grade, follow-up cohorts were developed that had similar metastatic risk. Using pre-determined thresholds for metastatic event, a follow-up schedule was established for each cohort. Based on our results we recommend that patients with small low-grade tumors undergo annual follow-up for 5 years following definitive local treatment. Patients with large low-grade tumors, small intermediate-grade and small high-grade tumors should have follow-up every 6 months for the first 2 years, then yearly to 10 years. Only patients with large intermediate- or high-grade tumors require follow-up every 3 months for the first 2 years, then every 6 months for years 3-5, followed by annually until 10 years.
Author	Griffin, Anthony M. Chung, Peter W. Wunder, Jay S. Ferguson, Peter C. Perrin, David Wilson, David A. J. Gazendam, Aaron Shultz, David Visgauss, Julia Catton, Charles N.
Author_xml	– sequence: 1 givenname: David A. J. surname: Wilson fullname: Wilson, David A. J. email: wilsondaj@gmail.com organization: Division of Orthopaedic Surgery, Department of Surgery, Juravinski Cancer Centre, McMaster University – sequence: 2 givenname: Aaron surname: Gazendam fullname: Gazendam, Aaron organization: Division of Orthopaedic Surgery, Department of Surgery, McMaster University – sequence: 3 givenname: Julia surname: Visgauss fullname: Visgauss, Julia organization: Department of Orthopedic Surgery, Duke University Medical Center, Duke University – sequence: 4 givenname: David surname: Perrin fullname: Perrin, David organization: University Musculoskeletal Oncology Unit, Division of Orthopaedic Surgery, Department of Surgery, Mount Sinai Hospital, University of Toronto – sequence: 5 givenname: Anthony M. surname: Griffin fullname: Griffin, Anthony M. organization: University Musculoskeletal Oncology Unit, Division of Orthopaedic Surgery, Department of Surgery, Mount Sinai Hospital, University of Toronto – sequence: 6 givenname: Peter W. surname: Chung fullname: Chung, Peter W. organization: Princess Margaret Cancer Centre, Department of Radiation Oncology, University of Toronto – sequence: 7 givenname: Charles N. surname: Catton fullname: Catton, Charles N. organization: Princess Margaret Cancer Centre, Department of Radiation Oncology, University of Toronto – sequence: 8 givenname: David surname: Shultz fullname: Shultz, David organization: Princess Margaret Cancer Centre, Department of Radiation Oncology, University of Toronto – sequence: 9 givenname: Peter C. surname: Ferguson fullname: Ferguson, Peter C. organization: University Musculoskeletal Oncology Unit, Division of Orthopaedic Surgery, Department of Surgery, Mount Sinai Hospital, University of Toronto – sequence: 10 givenname: Jay S. surname: Wunder fullname: Wunder, Jay S. organization: University Musculoskeletal Oncology Unit, Division of Orthopaedic Surgery, Department of Surgery, Mount Sinai Hospital, University of Toronto
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CitedBy_id	crossref_primary_10_1136_bmjopen_2022_070327 crossref_primary_10_3390_cancers16183157 crossref_primary_10_1007_s11548_023_02838_w crossref_primary_10_1302_2046_3758_109_BJR_2021_0014_R1 crossref_primary_10_3390_diagnostics13061206 crossref_primary_10_1038_s41698_024_00695_7 crossref_primary_10_1007_s11864_023_01064_5 crossref_primary_10_2106_JBJS_RVW_23_00217 crossref_primary_10_1245_s10434_023_13261_5 crossref_primary_10_2106_JBJS_23_01007 crossref_primary_10_1016_j_jorep_2022_100029 crossref_primary_10_1245_s10434_022_12953_8 crossref_primary_10_1155_2021_4740924
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Snippet	Purpose The risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to... The risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to determine... PurposeThe risk of tumor recurrence after resection of soft tissue sarcoma (STS) necessitates surveillance in follow-up. The objective of this study was to...
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SubjectTerms	Adult Aged Diagnostic Imaging Disease Progression Disease-Free Survival Evidence-Based Medicine Extremities - pathology Extremities - surgery Female Follow-Up Studies Humans Incidence Kaplan-Meier Estimate Male Medicine Medicine & Public Health Metastases Metastasis Middle Aged Neoplasm Grading Neoplasm Metastasis - diagnosis Neoplasm Recurrence, Local - diagnosis Oncology Predictive Value of Tests Retrospective Studies Sarcoma Sarcoma - diagnostic imaging Sarcoma - pathology Sarcoma - surgery Soft tissue sarcoma Surgery Surgical Oncology Time Factors Tumors
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Title	Designing a Rational Follow-Up Schedule for Patients with Extremity Soft Tissue Sarcoma
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