DOS 2016

DOS Kongressen 2016 ·

Surveillance for development of local recurrence after

primary surgical excision of soft tissue sarcomas and

borderline tumours of the extremities and trunk wall

Thea Hovgaard, Tine Nymark, Michael Mørk Petersen

Orthopaedic Department, Rigshospitalet; Orthopaedic Department, Odense

University Hospital; Orthopaedic Department, Rigshospitalet

Background:

Current routine follow-up policy for soft tissue sarcomas (STS)

lacks evidence. Early detection and surgical removal of a local recurrence (LR) is

associated with improved survival. In Jan 2010 we introduced a new follow-up

program for the first 2 postoperative years where STS were examined 4 times

a year; high-grade malignant STS alternating between clinical examination (CE)

preceded by focal MRI and chest CT-scan (CT) and a CE with chest X-ray (XR).

Low-grade malignant STS alternated between a CE and a CE preceded by focal

MRI.

Purpose / Aim of Study:

To evaluate the new surveillance program for iden-

tification of LR within the first 2 years postoperatively.

Materials and Methods:

We retrospectively assessed the medical files of all

patients (n=232, mean age 57 (18-88) years, F/M=117/115) with STS (in-

cluding borderline tumours) of the extremities and trunk wall, who underwent

surgery from 2010-2013. We extracted information on how LR were detected

during the first 25 months post-surgery. Statistics: Kaplan Meier survival anal-

ysis and 2x2 contingency table with chi2-test.

Findings / Results:

25/232 patients experienced LR within the first 25

months post-surgery (25 months-LR free rate 92%). Compared to CE, local

imaging (LI) mainly MRI led to a larger amount of suspicions of LR (37/557

versus 8/703, p<0.001). Furthermore the suspicions from LI were more ac-

curate than from CE (17/37 affirmed versus 0/8 affirmed, p<0.015). LI

(n=557) finds a larger number of LR than CE (n=703) (17 (3%) versus 0 (0%),

p<0.016). 33 patients suspected LR themselves; 8 of them were affirmed.

Conclusions:

Bi-annual LI (MRI) the initial first 2 postoperative years after

surgical treatment of STS, will detect LR better than CE, and therefore render

regular CE between these MRIs unnecessary, but patients´ own suspicion of LR

is still important.

No conflicts of interest reported