Follow-up for patients with extremity soft tissue sarcoma: validation of a rational schedule

PURPOSE: Patients with soft tissue sarcomas (STS) of the extremity require ongoing follow-up to detect treatment failures. There is a significant variation in follow-up schemes among sarcoma specialists due to a lack of evidence. METHODS: A retrospective single-center review was performed on all patients with a minimum 1-year follow-up after resection of a localized STS, utilizing a prospectively collected database. Kaplan-Meier curves were used to calculate the incidence of local recurrence and metastases on an annual basis over 10 years. RESULTS: There were 407 patients who met the inclusion criteria. Considering the annual incidence of local recurrence and distant metastasis per STS size and grade, patients with small, low-grade STS should be followed yearly for 10 years. Patients with small, intermediate/high-grade STS and those with large, low-grade STS should be followed every 6 months for the first 2 years and then yearly until 10 years postoperatively. Patients with large, intermediate/high-grade STS should be followed every 3 months for the first 2 years and then every 6 months thereafter until 10 years postoperatively. CONCLUSION: Compared to National Comprehensive Cancer Network (NCCN) and European Society for Medical Oncology (ESMO) guidelines, our proposed scheme has the potential to reduce hospital visits, mainly for patients with small intermediate and high-grade tumors. This protocol validates the previously published scheme, despite being relatively more conservative.