Pattern of care for follow-up of sarcoma after curative treatment: A survey of sarcoma specialists

Background Sarcomas are rare and complex malignancies with an average 5-year survival rate of 70%. Despite high recurrence rates after curative treatment, limited high-quality evidence exists to guide surveillance protocols, risking inconsistent follow-up care. We surveyed sarcoma specialists in Australia and New Zealand to assess current surveillance practices and identify discrepancies in management. Methods An online survey was distributed to 121 clinician members of the Australia and New Zealand Sarcoma Association in August 2023, focusing on surveillance practices across four hypothetical clinical scenarios representing common sarcoma presentations. The survey captured follow-up frequency, duration, and imaging modalities for local and distant recurrence surveillance. Responses were compared against published international guidelines. Results Forty-two clinicians (35% response rate) across all specialties responded. Most clinicians (66–75%) performed clinical follow-ups at intervals aligned with international recommendations. However, significant variation existed in three key areas: (1) only 35% continued surveillance for the guideline-recommended 10-year duration; (2) imaging modalities varied substantially, with MRI preferred for extremity sarcomas (82%) while CT and PET/CT showed variable use across scenarios (28–80%); and (3) imaging frequency declined earlier than recommended, particularly for adult sarcomas. Clinical factors influencing practice included tumour grade, location, and surgical margins. Access barriers included travel distance (52%), out-of-pocket costs (21%), and patient preferences (19%). Conclusions Surveillance practices among Australian and New Zealand sarcoma specialists show substantial heterogeneity despite general adherence to consultation frequency guidelines. Development of standardised guidelines and research to define optimal surveillance protocols are needed to reduce practice variation and potentially improve patient outcomes.