Clinical utility of routine surveillance CT/MRI imaging in patients with localized soft tissue sarcoma (STS) following curative resection

• Published in: Journal of clinical oncology Vol. 35; no. 15_suppl; p. 11069
• Main Authors: Lim, Chiew Woon, Harunal Rashid, Mohamad Farid Rin, Goh, Wei Lin, Tan, Sze Huey, Wong, Steven Bak Siew, Chan, Lai Peng, Hennedige, Tiffany Priyanthi, Selvarajan, Sathiyamoorthy, Sittampalam, Kesavan, Teh, Jonathan Yi Hui, Chin, Francis Kuok Choon, Tan, Mann Hong, Soo, Khee Chee, Teo, Melissa Ching Ching, Quek, Richard Hong Hui
• Format: Journal Article
• Language: English
• Published: 20.05.2017
• ISSN: 0732-183X; 1527-7755
• DOI: 10.1200/JCO.2017.35.15_suppl.11069

Abstract only 11069 Background: Guidelines recommend routine surveillance imaging in patients (pts) following curative resection of STS. However the benefit of such an approach is unclear. We sought to evaluate the utility of a surveillance imaging strategy in pts with localized STS treated with curative intent. Methods: Pts with localized non-indolent STS, seen between 2010 – 2016, who had undergone surgery with R0/R1 surgical margins were included. Epidemiology, treatment and relapse data were collected as was the mode of detection. We defined optimal surveillance as CT/ MRI performed at least 6-mthly following surgery; suboptimal surveillance was defined as CT/ MRI imaging performed less frequently than 6mthly. Results: Of 294 pts included, 31% (n = 92) vs 34% (n = 100) vs 35% (n = 102) had optimal, suboptimal and no routine CT/MRI surveillance imaging respectively. At a median follow-up of 27mths (range 0-79), 36% (n = 105) experienced a relapse; 43% (n = 45) local and 57% (n = 60) had metastatic relapse. More relapses were noted in the optimal surveillance group, 57% (n = 52) vs 28% (n = 28) and 25% (n = 25) in the suboptimal and no surveillance groups respectively (p < 0.001). Within each cohort, relapses detected directly by routine surveillance imaging vs outside of surveillance imaging were as follows: 35% (n = 32) / 22% (n = 20) in the optimal, 17% (n = 17) / 11% (n = 11) in the suboptimal and 0 / 25% (n = 25) in the no surveillance arms respectively. Comparing the 3 strategies, the proportion of pts who then went on to receive curative resection/ metastacectomy was not significantly different, 38% (n = 20), 57% (n = 16) and 32% (n = 8) of relapses, in the optimal vs suboptimal vs no surveillance cohorts respectively (p = 0.1). Notably, routine surveillance imaging directly leading to curative resection occurred only in 15% (n = 14) of pts in the optimal and 9% (n = 9) in the suboptimal surveillance groups. Conclusions: While an intensive routine CT/MRI surveillance imaging strategy detected more recurrences, the impact it has on subsequent resection is less certain. Optimal frequency of surveillance imaging remains unclear.