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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| Veröffentlicht in: | Annals of surgical oncology Jg. 27; H. 6; S. 2033 - 2041 |
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| Sprache: | Englisch |
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Springer International Publishing
01.06.2020
Springer Nature B.V |
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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. |
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| AbstractList | 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. 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.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. 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. |
| 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 |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/32152780$$D View this record in MEDLINE/PubMed |
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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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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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