|
| Recommendation | Phase | Type of consensus (% agreement) |
|
| Patients with excised low-grade STS who had negative resection margins should have | | |
| (i) Local MRI every 6 months during the first 2 years, as well as a physical exam every 3 or 6 months if considered appropriate | 2 | Yes (mode: 50) |
| (ii) Physical exam every 6 months and local MRI annually from 3rd to 5th year | 2 | Yes (mode: 68.3) |
| (iii) Physical exam and local MRI annually from 6th to 10th year | 2 | Yes (mode: 68.3) |
| (iv) No follow-up is necessary after 10th year | 1 | Yes (mode: 65) |
| Patients with low-grade resected STS with focally positive margins that cannot be widened should have the following: | | |
| (i) Physical exam and local MRI every 3-4 months during the first 2 years | 1 | Yes (mode: 70) |
| (ii) Physical exam and local MRI every 6 months from 3rd to 5th year | 1 | Yes (mode: 65) |
| (iii) Physical exam and local MRI annually from 6th to 10th year | 1 | Yes (mode: 70) |
| (iv) No imaging tests are necessary after 10th year, and no further follow-up can be considered vs. annual physical exam | 2 | — |
| Patients with high-risk (>5 cm, deep-seated, and high-grade) resected STS with focally positive margins that cannot be widened and who have only received complementary radiation therapy should have the following: | | |
| (i) Physical exam and local MRI every 3-4 months during the first 2 years | 1 | Yes (mode: 80) |
| (ii) Physical exam and local MRI every 6 months from 3rd to 5th year | 1 | Yes (mode: 80) |
| (iii) Physical exam and local MRI annually from 6th to 10th year | 1 | Yes (mode: 85) |
| (iv) No imaging tests are necessary after 10th year, and no further follow-up can be considered vs. annual physical exam | 2 | — |
| Patients with (<5 cm, deep-seated, and high-grade) resected STS with focally positive margins that cannot be widened and who have only received complementary radiation therapy should have the following: | | |
| (i) Physical exam and local MRI every 3-4 months during the first 2 years | 1 | Yes (mode: 80) |
| (ii) Physical exam and local MRI every 6 months from 3rd to 5th year | 1 | Yes (mode: 75) |
| (iii) Physical exam and local MRI annually from 6th to 10th year | 1 | Yes (mode: 75) |
| (iv) No imaging tests are necessary after 10th year, and no further follow-up can be considered | 2 | Yes (mode: 56) |
| Patients with localized intermediate-high-grade STS should have a chest CT scan every 3-4 months during the first 2 years, every 6 months from 3rd to 5th year, and thereafter annually until 10th year | 1 | Yes (mode: 70) |
| After resection of the pulmonary metastases, patients who have had metastatic disease should have a lung CT scan every 3 months during the first 2 years and subsequently every 6 months | 1 | Yes (80) |
| Factors to be taken into account to consider that a patient has progressed on a treatment and needs to change to a different one are as follows(in decreasing order of importance): | | |
| (i) Clinical progression | 2 | Yes (mean: 3.3; CV: 23.9%) |
| (ii) Progression based on RECIST criteria | 2 | Yes (mean: 3.1; CV: 25.2%) |
| PET-CT scans are considered especially useful prior to the resection of pulmonary metastases from STS | 2 | Yes (75) |
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