Meta-analysis questions routine imaging for patients with sarcoma post-treatment

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Although surveillance imaging is highly specific for detecting local recurrences, its sensitivity is low, indicating that it may not be an effective tool for identifying a significant portion of actual local recurrences, according to a study.

In contrast, for detecting metastatic pulmonary recurrences, surveillance imaging shows higher sensitivity and specificity, indicating greater effectiveness in this context.

The analysis, which included 10 studies encompassing 2160 patients with sarcoma, sought to evaluate the effectiveness of surveillance imaging in detecting local and metastatic pulmonary relapses.

For the detection of local recurrence, the sensitivity of surveillance imaging was found to be low at 13.6%, indicating that only a small fraction of actual local recurrences were identified through this method. However, the specificity was notably high at 99.5%, suggesting that when a recurrence was detected, it was likely to be accurate.

In contrast, the diagnosis of metastatic pulmonary recurrence showed more promising results. The sensitivity was notably higher at 76.1%, indicating a greater capacity for detecting pulmonary relapses, with a specificity of 99.3%.

The study did not find any evidence to support an overall-survival benefit associated with the use of surveillance imaging. This suggests that while the imaging approach may be effective in some cases, it may not significantly impact long-term survival rates.

Srinivasan S, Keerthivasagam S, Kumar S, Puri A. Impact of Surveillance Imaging in Detecting Local and Metastatic Lung Recurrences Among Patients with Sarcomas of the Extremities: A Systematic Review and Meta-analysis. Ann Surg Oncol. 2023;doi: 10.1245/s10434-023-14429-9. Epub ahead of print. PMID: 37865942.