Surveillance in patients with sarcoma of the extremities

Cool, Paul; Grimer, R. J.; Rees, Robin

doi:10.1016/j.ejso.2005.07.015

Cited by 32 publications

(52 citation statements)

References 17 publications

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“…In TOSS, almost 90% of local relapses were identified by the patients who presented to the clinic with symptomatic complaints, whereas 39% of pulmonary metastasis was initially detected based on patients' symptoms. Similar results have also been reported by others [5,8,11]. In Korholz et al's [12] series of relapsed patients with osteosarcoma, five of six local recurrences were detected by clinical symptoms.…”

Section: Discussionsupporting

confidence: 77%

“…One of the main strengths of TOSS in determining the ultimate impact of surveillance is the use of overall survival as an end point rather than detection rate as has been the norm in other studies [5,12]. CT scanning of the chest is known to be more sensitive than chest radiography in detecting lung lesions, but its specificity in detecting metastatic lesions is lower.…”

Section: Discussionmentioning

confidence: 99%

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Does Intensity of Surveillance Affect Survival After Surgery for Sarcomas? Results of a Randomized Noninferiority Trial

Puri

Gulia

Hawaldar

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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Background Whether current postoperative surveillance regimes result in improved overall survival (OS) of patients with extremity sarcomas is unknown. Questions/purposes We hypothesized that a less intensive followup protocol would not be inferior to the conventional followup protocol in terms of OS. We (1) assessed OS of patients to determine if less intensive followup regimens led to worsened survival and asked (2) whether chest radiograph followup group was inferior to CT scan followup group in detecting pulmonary metastasis; and (3) whether less frequent (6-monthly) followup interval was inferior to more frequent (3-monthly) followup in detecting pulmonary metastasis and local recurrence.Methods A prospective randomized single-center noninferiority trial was conducted between January 2006 and June 2010. On the basis of 3-year survival of 60% with intensive, more frequent followup, 500 nonmetastatic patients were randomized to demonstrate noninferiority by a margin (delta) of 10% (hazard ratio [HR], 1.36). The primary end point was OS at 3 years. The secondary objective was to compare disease-free survival (DFS) (time to recurrence) at 3 years. At minimum followup of 30 months (median, 42 months; range, 30-81 months), 178 deaths were documented. Results Three-year OS and DFS for all patients was 67% and 52%, respectively. Three-year OS was 67% and 66% in chest radiography and CT groups, respectively (HR, 0.9; upper 90% confidence interval [CI], 1.13). DFS rate was 54% and 49% in chest radiography and CT groups, respectively (HR, 0.82; upper 90% CI, 0.97). Three-year OS was 64% and 69% in 6-monthly and 3-monthly groups, respectively (HR, 1.2; upper 90% CI,

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Section: Discussionsupporting

confidence: 77%

Section: Discussionmentioning

confidence: 99%

Does Intensity of Surveillance Affect Survival After Surgery for Sarcomas? Results of a Randomized Noninferiority Trial

Puri

Gulia

Hawaldar

et al. 2014

Clinical Orthopaedics &Amp; Related Research

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“…Neste estudo, procurou-se analisar um grupo de pacientes submetidos a tratamento cirúrgico pela mesma equipe médica, na tentativa de validar os fatores prognósticos mais influentes no desenvolvimento de metástases, sendo as características da casuística como sexo, idade, subtipos e localização representativas dos pacientes com STM em geral. O tempo de seguimento foi também suficiente para detectar a ocorrência de metástases, já que a maioria destas ocorre nos dois primeiros anos de seguimento (13)(14) . A disseminação metastática foi observada em 40% dos casos, compatível com a literatura, que mostra incidência de metástases variando de 26,1% a 56,1% (2)(3)(4)(5)13,15) .…”

Section: Discussionunclassified

“…O tempo de seguimento foi também suficiente para detectar a ocorrência de metástases, já que a maioria destas ocorre nos dois primeiros anos de seguimento (13)(14) . A disseminação metastática foi observada em 40% dos casos, compatível com a literatura, que mostra incidência de metástases variando de 26,1% a 56,1% (2)(3)(4)(5)13,15) . Os fatores determinantes foram o tamanho maior do que 10cm, a localização extracompartimental, o alto grau de malignidade histológica e a presença de necrose e invasão vascular detectadas pela histologia.…”

Section: Discussionunclassified

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Fatores prognósticos para o desenvolvimento de metástases nos sarcomas de tecidos moles

Teixeira¹,

Araújo²,

Andrade³

et al. 2008

Rev. bras. ortop.

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10cm (p = 0,007), com o alto grau de malignidade (p = 0,007), com a presença de necrose (p = 0,002) e com a presença de invasão vascular (p = 0,034). A idade (p = 1,000), o sexo (0,709), a localização em segmentos corporais (p = 0,298), a profundidade (p = 0,288), a margem cirúrgica (p = 0,419) e a manipulação prévia do tumor (p = 1,000) não apresentaram correlação com a ocorrência de metástases a distância. Na análise multivariada apenas a localização extracompartimental (p = 0,008), o tamanho (p = 0,018) e a presença de invasão vascular (p = 0,043) foram significativos. CONCLUSÃO: O desenvolvimento de metástases a distância nos pacientes com sarcoma de tecidos moles depende da localização extracompartimental, do tamanho (> 10cm), do alto grau de malignidade histológica, da presença de necrose e da invasão vascular à histologia.]]>

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Follow‐up of the soft tissue sarcoma patient

Tseng

Amini

Madewell

2014

Journal of Surgical Oncology

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Despite optimal treatment, patients with soft tissue sarcoma are at risk for recurrence and therefore appropriate surveillance is critical. At minimum, regularly scheduled clinical assessments and chest X-rays are necessary. Consensus guidelines are available; however, surveillance strategies must be personalized based on the risk for recurrence and inherent disease biology. Further research is needed on a number of issues, including the impact of surveillance on clinical outcome and the utility of molecular surveillance.

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Surveillance in patients with sarcoma of the extremities

Cited by 32 publications

References 17 publications

Does Intensity of Surveillance Affect Survival After Surgery for Sarcomas? Results of a Randomized Noninferiority Trial

Does Intensity of Surveillance Affect Survival After Surgery for Sarcomas? Results of a Randomized Noninferiority Trial

Fatores prognósticos para o desenvolvimento de metástases nos sarcomas de tecidos moles

Follow‐up of the soft tissue sarcoma patient

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