Floriane De Angelis1, France Guy2, Aurélie Bertaut3, Nathalie Méjean2, Olivier Varbedian2, Alice Hervieu4, Gilles Truc5, David Thibouw5, Céline Charon Barra6, Jean Fraisse7, Pierre Burnier7, Nicolas Isambert4, Sylvain Causeret7. 1. Department of Radiology, Centre Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France; Department of Radiology, Centre Hospitalier Universitaire, 14 rue Paul Gaffarel, 21000, Dijon, France. Electronic address: fdeangelis@cgfl.fr. 2. Department of Radiology, Centre Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France. 3. Department of Statistic, Centre Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France. 4. Department of Oncology, Centre Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France. 5. Department of Radiotherapy, Centre Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France. 6. Department of Anatomopathology, Centre Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France. 7. Department of Surgery, Centre Georges François Leclerc, 1 rue du Professeur Marion, 21000, Dijon, France.
Abstract
INTRODUCTION: Soft tissue sarcomas (STS) are rare malignant tumors that require management by an expert center. Monitoring modalities are not consensual. The objective of our study is to report systematic radiological monitoring data obtained by local MRI and by thoracic-abdominal-pelvic computed tomography (TAP CT). MATERIAL AND METHODS: 113 consecutive patients managed at "Centre Georges François Leclerc, Dijon", between 2008 and 2016, for an initially localized STS were included. Patient follow-up consisted of a local MRI and a TAP CT. Follow-up exams schedule was initially every 4 months during 2 years, followed by every 6 months during 3 years and finally every year during 5 years. RESULTS: Median follow-up time was 37.2 months [min = 2.4 - max = 111.6]. After 5 years of surveillance, local recurrence (LR) rate was 8.8% and diagnosed by imaging in 60% of cases. No deep LR was clinically found. Median LR diagnosis time was 23.9 months [min = 2.0 - max = 52.4]. 50% of patients locally treated for their LR were alive without recurrence. Metastatic recurrence (MR) rate was 31%. 42.8% had extra-pulmonary involvement and 17.1% had exclusive extrathoracic metastases. The median time to diagnosis of MR was 17.4 months [min = 2.7- max = 77.2]. High-grade tumors relapsed more (20.4%) and earlier (all before the 5th year) than low grade. CONCLUSION: Local MRI seems particularly suitable for monitoring deep tumors. In addition, the systematic monitoring by TAP CT highlighted a limited number of cases of exclusive extrathoracic metastases. The schedule of local and remote monitoring should primarily be adjusted to tumor grade.
INTRODUCTION: Soft tissue sarcomas (STS) are rare malignant tumors that require management by an expert center. Monitoring modalities are not consensual. The objective of our study is to report systematic radiological monitoring data obtained by local MRI and by thoracic-abdominal-pelvic computed tomography (TAP CT). MATERIAL AND METHODS: 113 consecutive patients managed at "Centre Georges François Leclerc, Dijon", between 2008 and 2016, for an initially localized STS were included. Patient follow-up consisted of a local MRI and a TAP CT. Follow-up exams schedule was initially every 4 months during 2 years, followed by every 6 months during 3 years and finally every year during 5 years. RESULTS: Median follow-up time was 37.2 months [min = 2.4 - max = 111.6]. After 5 years of surveillance, local recurrence (LR) rate was 8.8% and diagnosed by imaging in 60% of cases. No deep LR was clinically found. Median LR diagnosis time was 23.9 months [min = 2.0 - max = 52.4]. 50% of patients locally treated for their LR were alive without recurrence. Metastatic recurrence (MR) rate was 31%. 42.8% had extra-pulmonary involvement and 17.1% had exclusive extrathoracic metastases. The median time to diagnosis of MR was 17.4 months [min = 2.7- max = 77.2]. High-grade tumors relapsed more (20.4%) and earlier (all before the 5th year) than low grade. CONCLUSION: Local MRI seems particularly suitable for monitoring deep tumors. In addition, the systematic monitoring by TAP CT highlighted a limited number of cases of exclusive extrathoracic metastases. The schedule of local and remote monitoring should primarily be adjusted to tumor grade.
Authors: Patrick England; Zachery Hong; Lee Rhea; Angela Hirbe; Douglas McDonald; Cara Cipriano Journal: Clin Orthop Relat Res Date: 2020-12 Impact factor: 4.755