The “how often” question relates to individual risks. If risk for recurrence and metastasis is very low, follow-ups can be less frequent than for a patient whose risk is high.
The difficulty for most patients with soft tissue sarcoma is that because there are so many varied subtypes of the disease, with such different characteristics, the risk and seriousness of sarcoma and the likelihood of recurrence after treatment vary widely. Moreover, because sarcomas are so rare and heterogenous, it is difficult to apply statistics drawn from large populations to individual patients. Discussing your individual situation with your doctor is the best way to determine the appropriate follow-up care for you.
Surveillance for Recurrence
Although each sarcoma patient is different, some generalizations can be made about follow-up and surveillance:
- About a third of patients treated for soft tissue sarcomas of the extremities, and more than half of those treated for sarcomas of the abdomen and trunk, have a recurrence either at the primary site or in another part of the body.
- Higher-grade and larger tumors have a higher risk of recurrence and metastasis, and such patients should receive more frequent and longer-term follow-up care than patients with lower-grade and smaller tumors. Patients with low-grade and small tumors (less than 5 centimeters) are routinely followed for five years with annual screening of the primary site. Patients with higher-grade and larger tumors may receive more intensive follow-up, every four or five months for the first three years after surgery. Patients with these higher-risk tumors also receive longer-term follow-up, some with annual MRI or CT scanning. Because the lungs are the most common organ to which soft tissue sarcomas spread, these patients usually receive lung x-rays once a year for five years.
- In the majority of patients whose disease recurs, the recurrence will appear in the first two years after treatment. After five years, recurrence of most sarcomas is rare. However, very late recurrences are possible. Memorial Sloan-Kettering’s Soft Tissue Sarcoma Disease Management Team usually follows patients for a minimum of ten years, which allows for the rapid treatment of such late recurrences, which can often be effectively treated.