Optimal surveillance for detecting sarcoma lung metastasis - A systematic review

Area of Science:

• Oncology
• Radiology
• Medical Imaging

Background:

• Accurate diagnosis of lung metastasis in soft tissue sarcoma (STS) is crucial for patient survival.
• Current practices for detecting metastasis vary, with chest X-ray (CXR) and chest CT scans being most common.

Purpose of the Study:

• To systematically review the literature on the effectiveness and cost-effectiveness of CXR versus CT chest for detecting lung metastasis in STS patients.
• To assess the impact of these imaging modalities on overall and recurrence-free survival.

Main Methods:

• A systematic literature search was conducted up to January 3, 2024.
• Studies were reviewed for data on survival, recurrence rates, and cost-effectiveness of CXR versus CT chest.
• The Critical Appraisal Skills Programme was used to assess evidence quality.

Main Results:

• Seven studies reported conflicting results on the impact of CXR versus CT chest on survival and recurrence.
• Four studies indicated CXR is more cost-effective, though chest CT may be cost-effective for specific patient groups.

Conclusions:

• Limited literature exists on optimal lung metastasis surveillance for STS.
• Most studies had low evidence quality, with significant bias.
• High-quality randomized controlled trials are necessary to determine the best imaging modality for STS lung metastasis surveillance.