Key result
Patients over 55 years of age with adult fibrosarcoma had a significantly higher risk for tumor recurrence (RR 5) compared to younger patients.
Why the study?
Adult fibrosarcoma is a very rare malignant soft tissue tumor, prompting an analysis of the appearance of recurrent disease on MRI follow-up with a focus on configuration and loco-regional post-treatment changes.
Observational (n=12)
Reviewers were blinded to clinical and patient data
No
Relative Risk: 5 (95% CI 1.8–31)
p-value: p=0.04
Recurrent adult fibrosarcoma presents with highly variable configurations on MRI, and patients over 55 years of age or with post-treatment muscle edema may be at higher risk for recurrence.
May warrant closer surveillance in patients >55; hypothesis-generating for MRI-based recurrence prediction in adult fibrosarcoma.
Background Adult fibrosarcoma (AFS) is a very rare malignant soft tissue tumor, arising from malignant spindle-shaped fibroblasts. We aim to analyze the appearance of recurrent AFS with a focus on configuration and to assess the occurrence of loco-regional post-treatment changes on MRI follow-up. Methods One hundred sixty-eight MRI follow-up scans (1.5 T MRI) of 12 patients with histologically proven AFS were reviewed. The recurrent tumors were examined for configuration, limitation, contrast enhancement, and extent and signal intensity on MRI. Results The mean age of the patients was 50.2 ± 16.7 years. Forty-two percent of the patients presented recurrent AFS ( n = 5). Recurrences occurred 12 ± 6.5 months after tumor resection in the mean. Patients over 55 years of age showed a significantly higher risk for recurrences (RR = 5; 95% CI, 1.8 to 31; p = 0.04). Recurrent AFS was ovoid, nodular, streaky, polycyclic, or fascicular configured with homogeneous/heterogeneous contrast enhancement and well- or ill-defined borders. The intensity of contrast enhancement ranged from rim to marked contrast enhancement. Recurrent AFS mostly showed a muscle iso-intense signal in T1-weighted and a hyperintense signal in PD-weighted/TIRM sequences. The most common post-treatment changes were subcutaneous edema (92%; p = 0.03), muscle edema (75%), and postoperative seroma (50%). Patients with the presence of muscle edema after primary tumor resection had a slightly, but not significantly higher risk for recurrences (RR = 1.75; p = 0.08). Conclusion Recurrent AFS shows no common configuration on MRI, as it may appear ovoid, nodular, streaky, polycyclic, or fascicular. Patients with the presence of post-treatment muscle edema have a slightly higher risk for recurrences. Level of evidence: Level III, therapeutic study
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Sedaghat et al. (2020) conducted an observational in Adult fibrosarcoma (n=12). Age over 55 years vs. Age 55 years or younger was evaluated on Tumor recurrence (RR 5, 95% CI 1.8 to 31, p=0.04). Patients over 55 years of age with adult fibrosarcoma had a significantly higher risk for tumor recurrence (RR 5) compared to younger patients.
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