10582 Background: The role of systematic magnetic resonance imaging (MRI) surveillance after resection of soft-tissue sarcomas (STS) of the limb is opened to debate. The aim of our study was to retrospectively evaluate the effectiveness of a MRI surveillance schedule performed in adult patients. Methods: 124 adult patients have been treated from 1996 to 2006 for a non-metastatic limb STS at our centre: 86 patients (70%) had clear resection margins (R0) and 111 patients (90%) received an adjuvant radiotherapy. 663 MRI examinations were performed, with a median of 5 per patient [range: 1 to 5]. The rythm of surveillance schedule was respected in 57% of the examinations. Results: Forty-one patients (33%) prematurely withdrew from the planned radiological surveillance due to metastasis diagnosis (15 cases), 5-year remission duration (5 cases), other reasons (12 cases), and drop out (9 cases). Among the 11 local recurrences (9%) which were observed, MRI was able to detect only 2 asymptomatic local recurrences, 1 with and 1 without synchronous metastasis, both had microscopically involved margins (R1). In contrast, MRI showed 11 false-positive cases. As the predictive positive value of MRI was 42%, clinical surveillance seems to be more effective. The evaluation of the cost of the systematic MRI surveillance is 200,000 euros. Clinical examination failed in 2 cases (2 asymptomatic local recurrences detected by MRI) as did MRI surveillance (2 false negative cases). In our study, cost-effectiveness was better with clinical examination than MRI surveillance. Conclusions: As observed in our study, systematic MRI surveillance is not relevant for the follow-up of all limb soft-tissue sarcomas. A prospective study could be promoted to evaluate the MRI surveillance of patient at high risk of local recurrence. No significant financial relationships to disclose.
Ledderhose Disease: Clinical, Radiological (Ultrasound and MRI), and Anatomopathological Findings
