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Follow-Up after Curative Surgical Treatment of Soft-Tissue Sarcoma for Early Detection of Recurrence: Which Patients Have More or Fewer Visits than Advised in Guidelines?

SIMPLE SUMMARY: Soft-tissue sarcoma patients need regular check-ups after surgery to detect disease recurrence as early as possible. However, the current guidelines for follow-up are not based on strong evidence and do not consider individual patient or tumor characteristics. This has led to debates...

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Autores principales: Kruiswijk, Anouk A., Kuhrij, Laurien S., Dorleijn, Desiree M. J., van de Sande, Michiel A. J., van Bodegom-Vos, Leti, Marang-van de Mheen, Perla J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: MDPI 2023
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527323/
https://www.ncbi.nlm.nih.gov/pubmed/37760585
http://dx.doi.org/10.3390/cancers15184617
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author Kruiswijk, Anouk A.
Kuhrij, Laurien S.
Dorleijn, Desiree M. J.
van de Sande, Michiel A. J.
van Bodegom-Vos, Leti
Marang-van de Mheen, Perla J.
author_facet Kruiswijk, Anouk A.
Kuhrij, Laurien S.
Dorleijn, Desiree M. J.
van de Sande, Michiel A. J.
van Bodegom-Vos, Leti
Marang-van de Mheen, Perla J.
author_sort Kruiswijk, Anouk A.
collection PubMed
description SIMPLE SUMMARY: Soft-tissue sarcoma patients need regular check-ups after surgery to detect disease recurrence as early as possible. However, the current guidelines for follow-up are not based on strong evidence and do not consider individual patient or tumor characteristics. This has led to debates, especially due to concerns about cost, radiation frequency, and possible over-testing. The goal of this study was to see how often patients received the recommended follow-up visits and to identify which type of patients received more or fewer visits than advised. The results show that only 24% of patients received the advised three follow-up visits in the first year after surgery. More follow-up visits were observed in younger patients and those diagnosed with a high-grade tumor, suggesting that doctors incorporate the patient’s risk of recurrence in their decision on follow-up frequency. The results of this study can help to improve follow-up practices, taking the risk of disease recurrence into account while avoiding unnecessary costs and tests. ABSTRACT: Introduction: Follow-up (FU) in soft-tissue sarcoma (STS) patients is designed for early detection of disease recurrence. Current guidelines are not evidenced-based and not tailored to patient or tumor characteristics, so they remain debated, particularly given concerns about cost, radiation frequency, and over-testing. This study assesses the extent to which STS patients received guideline-concordant FU and to characterize which type of patients received more or fewer visits than advised. Methods: All STS patients surgically treated at the Leiden University Medical Center between 2000–2020 were included. For each patient, along with individual characteristics, all radiological examinations from FU start up to 5 years were included and compared to guidelines. Recurrence was defined as local/regional recurrence or metastasis. Results: A total of 394 patients was included, of whom 250 patients had a high-grade tumor (63.5%). Only 24% of patients received the advised three FU visits in the first year. More FU visits were observed in younger patients and those diagnosed with a high-grade tumor. Among patients with a recurrence, 10% received fewer visits than advised, while 28% of patients without a recurrence received more visits than advised. Conclusions: A minority of STS patients received guideline-concordant FU visits, suggesting that clinicians seem to incorporate recurrence risk in decisions on FU frequency.
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spelling pubmed-105273232023-09-28 Follow-Up after Curative Surgical Treatment of Soft-Tissue Sarcoma for Early Detection of Recurrence: Which Patients Have More or Fewer Visits than Advised in Guidelines? Kruiswijk, Anouk A. Kuhrij, Laurien S. Dorleijn, Desiree M. J. van de Sande, Michiel A. J. van Bodegom-Vos, Leti Marang-van de Mheen, Perla J. Cancers (Basel) Article SIMPLE SUMMARY: Soft-tissue sarcoma patients need regular check-ups after surgery to detect disease recurrence as early as possible. However, the current guidelines for follow-up are not based on strong evidence and do not consider individual patient or tumor characteristics. This has led to debates, especially due to concerns about cost, radiation frequency, and possible over-testing. The goal of this study was to see how often patients received the recommended follow-up visits and to identify which type of patients received more or fewer visits than advised. The results show that only 24% of patients received the advised three follow-up visits in the first year after surgery. More follow-up visits were observed in younger patients and those diagnosed with a high-grade tumor, suggesting that doctors incorporate the patient’s risk of recurrence in their decision on follow-up frequency. The results of this study can help to improve follow-up practices, taking the risk of disease recurrence into account while avoiding unnecessary costs and tests. ABSTRACT: Introduction: Follow-up (FU) in soft-tissue sarcoma (STS) patients is designed for early detection of disease recurrence. Current guidelines are not evidenced-based and not tailored to patient or tumor characteristics, so they remain debated, particularly given concerns about cost, radiation frequency, and over-testing. This study assesses the extent to which STS patients received guideline-concordant FU and to characterize which type of patients received more or fewer visits than advised. Methods: All STS patients surgically treated at the Leiden University Medical Center between 2000–2020 were included. For each patient, along with individual characteristics, all radiological examinations from FU start up to 5 years were included and compared to guidelines. Recurrence was defined as local/regional recurrence or metastasis. Results: A total of 394 patients was included, of whom 250 patients had a high-grade tumor (63.5%). Only 24% of patients received the advised three FU visits in the first year. More FU visits were observed in younger patients and those diagnosed with a high-grade tumor. Among patients with a recurrence, 10% received fewer visits than advised, while 28% of patients without a recurrence received more visits than advised. Conclusions: A minority of STS patients received guideline-concordant FU visits, suggesting that clinicians seem to incorporate recurrence risk in decisions on FU frequency. MDPI 2023-09-18 /pmc/articles/PMC10527323/ /pubmed/37760585 http://dx.doi.org/10.3390/cancers15184617 Text en © 2023 by the authors. https://creativecommons.org/licenses/by/4.0/Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https://creativecommons.org/licenses/by/4.0/).
spellingShingle Article
Kruiswijk, Anouk A.
Kuhrij, Laurien S.
Dorleijn, Desiree M. J.
van de Sande, Michiel A. J.
van Bodegom-Vos, Leti
Marang-van de Mheen, Perla J.
Follow-Up after Curative Surgical Treatment of Soft-Tissue Sarcoma for Early Detection of Recurrence: Which Patients Have More or Fewer Visits than Advised in Guidelines?
title Follow-Up after Curative Surgical Treatment of Soft-Tissue Sarcoma for Early Detection of Recurrence: Which Patients Have More or Fewer Visits than Advised in Guidelines?
title_full Follow-Up after Curative Surgical Treatment of Soft-Tissue Sarcoma for Early Detection of Recurrence: Which Patients Have More or Fewer Visits than Advised in Guidelines?
title_fullStr Follow-Up after Curative Surgical Treatment of Soft-Tissue Sarcoma for Early Detection of Recurrence: Which Patients Have More or Fewer Visits than Advised in Guidelines?
title_full_unstemmed Follow-Up after Curative Surgical Treatment of Soft-Tissue Sarcoma for Early Detection of Recurrence: Which Patients Have More or Fewer Visits than Advised in Guidelines?
title_short Follow-Up after Curative Surgical Treatment of Soft-Tissue Sarcoma for Early Detection of Recurrence: Which Patients Have More or Fewer Visits than Advised in Guidelines?
title_sort follow-up after curative surgical treatment of soft-tissue sarcoma for early detection of recurrence: which patients have more or fewer visits than advised in guidelines?
topic Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10527323/
https://www.ncbi.nlm.nih.gov/pubmed/37760585
http://dx.doi.org/10.3390/cancers15184617
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