Early Imaging Needed to Detect Metastases in Extremity Soft Tissue Sarcoma

Abdominal ultrasonography/CT scans or whole-body-MRI should be performed at an early stage to detect abdominal metastases (AM) and retroperitoneal metastases (RM) in patients with extremity soft tissue sarcoma (eSTS), according to a study published inworld Journal of Clinical Oncology.

In this systematic review, researcher analyzed 17 articles for on AM or RM in eSTS.

Six were original articles reporting on incidence ± diagnosis, therapy and outcome in AM and RM; 3 were original; and 8 were case reports focused on diagnostic pathway, therapeutic procedures or outcomes without allowing conclusions regarding incidence of AM and RM.

In the first 6 articles, in patients with miscellaneous histological subtypes AM ranged from 0.9%-5.6%, whereas AM in patients with myxoid liposarcoma occurred in 12.1%.

Liposarcoma and leiomyosarcoma were the most common histological subtypes to develope AM or RM. Epithelioid sarcoma, myxofibrosarcoma, synovial sarcoma, and malignant peripheral nerve sheath tumor were also reported to develop AM/RM.

In the analyzed case reports, surgery for AM/RM was performed 62.5% of cases. In the original articles, surgery was performed anywhere from 20.8% to 100.0%. Patients with hepatic metastases who underwent metastasectomy had a >3 years survival benefit compared to patients treated with chemotherapy or best supportive care (<6 months).

The authors concluded that, “Patients with eSTS should undergo surveillance with abdominal ultrasonography/computed tomography, or even whole-body-magnetic resonance imaging to detect AM/RM at an early stage.”

Reference

Smolle MA, Leithner A, Bernhardt GA. Abdominal metastases of primary extremity soft tissue sarcoma: A systematic review. World J Clin Oncol. 2020;11(2):74–82.