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Current follow‐up strategies after potentially curative resection of extremity sarcomas
Author(s) -
Beitler Alan L.,
Virgo Katherine S.,
Johnson Frank E.,
Gibbs John F.,
Kraybill William G.
Publication year - 2000
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/(sici)1097-0142(20000215)88:4<777::aid-cncr7>3.0.co;2-r
Subject(s) - medicine , sarcoma , orthopedic surgery , surgery , regimen , general surgery , physical therapy , pathology
BACKGROUND The follow‐up of patients after potentially curative resection of extremity sarcomas has significant clinical and fiscal implications. However, the ideal postoperative surveillance regimen for these uncommon neoplasms remains ill‐defined. This study was designed to determine the current follow‐up practices of a large, diverse group of physicians who care for sarcoma patients. METHODS The 1592 members of the Society of Surgical Oncology (SSO) were surveyed regarding their follow‐up practices with a detailed questionnaire mailed in 1997. Information regarding frequency of follow‐up testing was requested for extremity sarcoma patients treated for cure based on 4 vignettes: low grade lesion ≤ 5 cm and > 5 cm and high grade lesion ≤ 5 cm and > 5 cm. Respondents were asked to indicate the number of office visits, laboratory tests and imaging studies performed annually during the first 5 years and the 10th year after surgery. RESULTS Forty‐five percent (716 of 1592) completed the survey. Of the 343 respondents who performed sarcoma surgery, 318 (93%) also provided long term postoperative follow‐up for their patients. Ninety‐four percent of respondents (295 of 318) were trained in general surgery and 5% (15 of 318) completed orthopedic residencies. Ninety‐one percent (291 of 318) were also fellowship trained (80% in surgical oncology). Sixty‐three percent (201 of 318) were in academic practice. Routine office visits and chest X‐ray (CXR) were the most frequently performed items for each of the years. The frequency of office visits and CXR increased with tumor size and grade and decreased with postoperative year. Complete blood count and liver function tests were the most commonly ordered blood tests, but many respondents did not order any blood tests routinely. Imaging studies of the extremities were performed on the majority of patients with large (> 5 cm) low grade lesions and on both large and small high grade lesions during the first postoperative year. CONCLUSIONS Postoperative sarcoma surveillance strategies utilized by members of the SSO rely most heavily on office visits and CXR. Tumor grade, tumor size, and postoperative year affect surveillance intensity. Cancer 2000;88:777–85. © 2000 American Cancer Society.