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Routine bone scintigraphy in primary staging of soft tissue sarcoma; Is it worthwhile?
P L Jager1, H J Hoekstra, J Leeuw
1Department of Nuclear Medicine, University Hospital Groningen, Groningen, The Netherlands. p.l.jager@nucl.azg.nl
Cancer
|October 24, 2000
Summary
Bone metastases are rare in soft tissue sarcoma (STS) patients, occurring in 7% of cases. Bone scans are most valuable for symptomatic patients, as routine scanning in asymptomatic individuals yields limited information.
Area of Science:
- Oncology
- Radiology
- Surgical Oncology
Background:
- Bone metastases in soft tissue sarcoma (STS) are not well-characterized.
- Previous studies have not specifically analyzed bone metastasis incidence in STS.
Purpose of the Study:
- To evaluate the utility of routine radionuclide bone scanning for preoperative staging in STS patients.
- To determine the incidence and significance of bone metastases in STS.
Main Methods:
- Retrospective analysis of preoperative bone scans in 109 STS patients (intermediate/high grade).
- Bone scans categorized as: 1 (metastases likely), 2 (equivocal), 3 (normal/benign).
Main Results:
- Bone metastases confirmed in 7% of patients (Category 1).
- Higher incidence in rhabdomyosarcoma subgroup (17%).
- Bone metastases were as frequent as lung metastases (4%) and occurred as the sole systemic disease site in 4% of cases. Incidence significantly higher in patients with bone pain (55%) vs. without (2%).
Conclusions:
- Bone metastases are infrequent but significant in primary STS, occurring at a rate comparable to lung metastases.
- Bone scanning is recommended for symptomatic patients due to a higher yield.
- Routine bone scanning in all STS patients has a low diagnostic yield.