Systematic Review
Copyright ©The Author(s) 2020. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Oncol. Feb 24, 2020; 11(2): 74-82
Published online Feb 24, 2020. doi: 10.5306/wjco.v11.i2.74
Abdominal metastases of primary extremity soft tissue sarcoma: A systematic review
Maria Anna Smolle, Andreas Leithner, Gerwin Alexander Bernhardt
Maria Anna Smolle, Andreas Leithner, Gerwin Alexander Bernhardt, Department of Orthopaedics and Trauma, Medical University of Graz, Graz 8036, Austria
Author contributions: All authors contributed to the present manuscript by performing literature review, summarizing data, compiling tables, and writing as well as reviewing the manuscript.
Conflict-of-interest statement: None of the authors has any potential conflicts of interest related to this review to declare.
PRISMA 2009 Checklist statement: The PRISMA 2009 Checklist has been added at the end of the manuscript.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Corresponding author: Gerwin Alexander Bernhardt, FACS, Associate Specialist, Department of Orthopaedics and Trauma, Medical University of Graz, Auenbruggerplatz 5, Graz 8036, Austria. gerwin.bernhardt@medunigraz.at
Received: March 20, 2019
Peer-review started: March 20, 2019
First decision: May 7, 2019
Revised: August 25, 2019
Accepted: December 6, 2019
Article in press: December 6, 2019
Published online: February 24, 2020
ARTICLE HIGHLIGHTS
Research background

Currently, there is no clear consensus on the best imaging modality or follow-up duration for patients with primary extremity soft tissue sarcoma (eSTS), which is important to detect metastases to unusual sites, including the abdomen and retroperitoneum.

Research motivation

There is limited knowledge on incidence, treatment and outcome of abdominal metastases (AM) and retroperitoneal metastases (RM) in patients with primary eSTS undergoing surgery with curative intent.

Research objectives

The objective of the present systematic review was to summarise current knowledge on incidence, diagnosis, treatment and outcome of AM and RM in eSTS patients.

Research methods

A systematic literature review was performed, screening all studies published in PubMed between January, 2000 and December, 2018 adhering to the PRISMA guidelines. Of 899 articles screened, 17 were eligible to be included in the present review.

Research results

Six original articles of the 17 studies provided information on incidence ± diagnosis, therapy and outcome, whilst three original articles and eight case reports did not allow for conclusions on the incidence of AM/RM. Incidence of AM/RM ranged between 0.9%-12.1%, depending on the underlying histological subtype. (Myxoid) liposarcoma and leiomyosarcoma were the prevalent histological subtypes, although rare entities had also been reported to develop AM/RM. Surgery was performed in 62.5% of case reports and in 20.8%-100.0% of original articles, with patients undergoing metastasectomy having an improved outcome. Especially in patients with hepatic metastases, metastasectomy was associated with improved post-metastasis survival.

Research conclusions

Abdominal ultrasonography/ computed tomography (CT) should be performed on a regular basis during follow-up in eSTS patients. In patients with a high risk of developing AM/RM– especially those with myxoid liposarcoma – even whole-body magnetic resonance imaging may be considered.

Research perspectives

Prospective studies investigating the effect of surveillance with abdominal ultrasonography or CT scans of the abdomen for reporting incidences of AM/RM as well as patient outcome are warranted.