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

Richardson, Kyle; Potter, Michael; Damron, Timothy A.

doi:10.1002/jso.24230

Cited by 13 publications

(8 citation statements)

References 9 publications

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“…The purpose of these scans is to look for distant sites of disease, most notably pulmonary metastases, because the lung is the most common site of metastasis in patients with both soft tissue and bone sarcoma [1, 6-8, 17, 21]. Many times the initial imaging studies will report additional findings, which may or may not be related to the known malignancy [14,20,21]. The clinician then must determine if these additional findings are nonneoplastic or benign and unrelated to the underlying sarcoma, are related to the underlying malignancy, or represent an important additional medical condition that should have further intervention.…”

Section: Introductionmentioning

confidence: 99%

“…Two recent studies have been conducted on the incidence of incidental findings at staging CT scan in prostate and colorectal cancer [10,15]. However, there are few reports on the frequency of incidental findings at the time of staging CT scan in patients with sarcoma [14,20]. Indeterminate nodules or findings of uncertain importance in the lung, liver, bone, and lymph nodes are commonly seen on staging examinations for sarcoma and may indicate the presence of metastatic disease, unrelated benign lesions, or nonneoplastic coincident conditions [1-4, 6-9, 11, 17, 19-22, 24].…”

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

What Is the Clinical Importance of Incidental Findings on Staging CT Scans in Patients With Sarcoma?

Mayo

Kennedy

Gao

et al. 2018

Clin Orthop Relat Res

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Background Baseline staging CT scans are performed on nearly every patient after the diagnosis of a sarcoma to evaluate for the presence of metastatic disease. These scans often identify abnormalities that may or may not be related to the known malignancy. Despite the high frequency of incidental findings, there is little guidance for clinicians faced with assessing these radiographic abnormalities. The interpretation of incidental findings is important because it may influence decisions regarding surveillance frequency, prognostic estimation, and surgical and medical intervention. Questions/purposes The purpose of this study was to determine (1) the frequency of abnormal findings and indeterminate nodules on staging CT scans; (2) the natural history of indeterminate nodules identified at the time of sarcoma diagnosis; and (3) the factors associated with indeterminate nodules representing true metastatic disease.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

What Is the Clinical Importance of Incidental Findings on Staging CT Scans in Patients With Sarcoma?

Mayo

Kennedy

Gao

et al. 2018

Clin Orthop Relat Res

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“…The lungs are the most common organ for the metastasis of soft-tissue sarcomas, which progresses extremely fast. The tremendous aggressiveness of the soft-tissue sarcomas could partially explain the high mortality rates [ 3 , 7 – 12 ].…”

Section: Introductionmentioning

confidence: 99%

Prediction of clinical outcome and survival in soft-tissue sarcoma using a ten-lncRNA signature

Wei

Tang

et al. 2017

Oncotarget

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The prognostic value of long non-coding RNAs (lncRNAs) in patients with soft-tissue sarcoma has rarely been unraveled. The aim of the study was to find a lncRNA signature to predict the clinical outcome and survival in soft-tissue sarcoma based on the high-throughput RNA-seq data from The Cancer Genome Atlas (TCGA) database. The lncRNAs which closely correlated with overall survival in 258 soft-tissue sarcoma patients were identified with Cox proportional regression model. Ten lncRNAs, including RP11-560J1.2, AP001432.14, RP4-665J23.1, LINC00680, AC006129.2, RP11-230G5.2, BACH1-IT2, RP11-274B21.9, RP11-504A18.1 and RP11-713P17.3, were selected to calculate a risk score. The risk score could effectively predict patients’ outcome, such as the status of mitotic count of tumor cells, person neoplasm cancer and residual tumor. More inspiringly, the risk score generated from the 10-lncRNA signature was an independent prognostic indicator for soft-tissue sarcoma patients. Overall, this 10-lncRNA signature gains the potential as an effective prognostic tool for soft-tissue sarcoma as part of the integrated clinical RNA-seq program.

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“…According to the German guidelines on soft tissue sarcoma [5] and American College of Radiology (ACR) Appropriateness Criteria Guidelines [36], MRI is the appropriate modality for surveillance of local recurrence. Several groups found that local surveillance by MRI identified a larger amount of local recurrence than clinical examination [30,[37][38][39]. Reuther and Mutschler reported than MRI has a higher sensitivity compared to CT in tumors larger than 15 cm [40], and Diana Afonso et al demonstrated the advantages of using contrast-enhanced MRI [41].…”

Section: Discussionmentioning

confidence: 99%

Efficacy and Cost-Benefit Analysis of Magnetic Resonance Imaging in the Follow-Up of Soft Tissue Sarcomas of the Extremities and Trunk

Kraus

Oettinger

Kiefer

et al. 2021

Journal of Oncology

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There is no consensus regarding follow-up after soft tissue sarcoma (STS) treatment. This study examines the efficacy and the cost-benefit of MRI imaging for discovering recurrence. A retrospective analysis was performed, collecting data on patient demography, tumor characteristics, treatment, and follow-up. Imaging was correlated to the clinical course, and sensitivity, specificity, and predictive values were calculated. The number needed to screen and costs of finding recurrence are reported. Amongst 216 sarcomas, 73 (35%) exhibited local recurrence during a follow-up of 5.3 ± 3.5 years. 173 entities had complete MRI follow-up with 58 (34%) local recurrences. Thirty-three (57%) were discovered by MRI, 8 (14%) by clinical presentation, and 17 (29%) simultaneously. There was a sensitivity of 100.00%, a specificity of 89%, a positive predictive value of 32%, and a negative predictive value of 100% for detecting local recurrence with MRI. Our data confirm the modalities and intervals proposed by the German guidelines for sarcoma care. The recommended MRI intervals should not be extended. MRI is more cost-effective than clinical examination; still, both modalities should be performed together to discover the maximum number of recurrences.

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

Cited by 13 publications

References 9 publications

What Is the Clinical Importance of Incidental Findings on Staging CT Scans in Patients With Sarcoma?

What Is the Clinical Importance of Incidental Findings on Staging CT Scans in Patients With Sarcoma?

Prediction of clinical outcome and survival in soft-tissue sarcoma using a ten-lncRNA signature

Efficacy and Cost-Benefit Analysis of Magnetic Resonance Imaging in the Follow-Up of Soft Tissue Sarcomas of the Extremities and Trunk

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