If a woman gets diagnosed with an abdominal sarcoma, her oncologist can check the National Comprehensive Cancer Network's soft-tissue sarcoma guidelines, written by some of the top doctors in sarcoma centers across the United States.
If a woman gets diagnosed with the same sarcoma subtype in her uterus, her oncologist will be steered to the uterine neoplasms guidelines, written by top gynecologic oncologists.
The guidelines for uterine sarcomas recommend a patient get a physical exam every three months for two years, plus a chest X-ray annually. "CT/MRI as clinically indicated." This replaced the previous recommendation of: "Chest/abdomen/pelvis imaging every 3-6 mo for 2 y, then annually."
Meanwhile, the soft-tissue sarcoma guidelines recommend a physical exam, plus CT scans of the abdomen/pelvis, every 3-6 months for 2-3 years for someone whose tumor started in the abdomen. "Consider chest imaging." These guidelines also have much more information on new drugs and genetics for sarcoma.
I don't understand why there are different standards, nor do I understand why chest imaging is not recommended more highly, considering that some subtypes migrate to the lungs.
In 2005, I asked Dr. Robert Benjamin about the NCCN guidelines, and he said sarcoma doctors would write the ones for uterine sarcomas in the future. That future has not yet come.
-- Suzie Siegel
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