Follow-up Guidelines

Surveillance Schedules

Follow-up Guidelines

25 guidelines

Category

25 guidelines

BoneDischarge 3 years

Benign Bone Tumours

Aneurysmal bone cyst, Giant cell tumour of bone

  1. 1

    Year 1

    • Post-operative visit within first 6 weeks; 3–6 monthly clinical examination and plain films of primary site
  2. 2

    Years 2–3

    • 6-monthly clinical examination and plain films of primary site

Discharge

Discharge 3 years after surgery

BoneDischarge 10 years

Chordoma - Post Resection ± Radiotherapy

Chordoma, localised post-resection with or without radiotherapy

  1. 1

    Years 1–2

    • Post-operative visit within first 6 weeks; 3–6 monthly clinical examination and CXR; MRI of primary site at 6 months, 1 year, and 2 years
  2. 2

    Years 3–5

    • 6-monthly clinical examination and CXR; MRI of primary site annually
  3. 3

    Years 6–10

    • Annual clinical examination, CXR, and MRI of primary site

Discharge

Discharge at 10 years from surgery

BoneDischarge criteria

Grade 1 Chondrosarcoma - Observation Only

Grade 1 chondrosarcoma, localised on observation only (no surgery)

  1. 1

    Years 1–2

    • Interval MRI scans at 6 months and 18 months
    • If no change and patient does not want curettage - discharge

Discharge

Discharge if no change on MRI at 18 months and patient does not wish to proceed to curettage

BoneDischarge 5 years

Grade 1 Chondrosarcoma - Post Curettage ± Cementation

Grade 1 chondrosarcoma, localised post curettage with or without cementation

  1. 1

    Year 1

    • Post-operative visit within first 6 weeks; 3–6 monthly clinical examination and plain films of primary site
  2. 2

    Years 2–5

    • 6-monthly clinical examination and plain films of primary site

Discharge

Discharge at 5 years from surgery

BoneDischarge 10 years

Grade 2–3 Chondrosarcoma, Periosteal and Parosteal Osteosarcoma - Post Resection

Grade 2–3 chondrosarcoma, periosteal osteosarcoma, parosteal osteosarcoma, localised post-resection

  1. 1

    Years 1–2

    • Post-operative visit within first 6 weeks; 3-monthly clinical examination, plain films of primary site, and CXR
  2. 2

    Years 3–5

    • 6-monthly clinical examination, plain films of primary site, and CXR
  3. 3

    Years 6–10

    • Annual clinical examination, plain films of primary site, and CXR

Discharge

Discharge at 10 years from surgery

BoneDischarge 10 years

Ewing's Sarcoma / Rhabdomyosarcoma - Localised Post Primary Treatment

Ewing's sarcoma, rhabdomyosarcoma, localised post primary treatment

  1. 1

    Year 1

    • 2-monthly clinical examination, CXR, plain films of primary bony site; soft tissue tumours - baseline end-of-treatment MRI/CT primary site, thereafter at clinician's discretion; radiotherapy as definitive local treatment - baseline end-of-treatment MRI/CT, then at 6 and 12 months; end of Year 1 - gonadal function and renal function
  2. 2

    Years 2–3

    • 3-monthly clinical examination, CXR, plain films of bony primary site; MRI of soft tissue primary site at clinician's discretion; radiotherapy patients - MRI/CT at 18 and 24 months; MUGA/ECHO 2 years post-diagnosis; annual renal function
  3. 3

    Year 4

    • 6-monthly clinical examination, CXR, plain films of primary site; MRI of soft tissue primary at clinician's discretion; MUGA/ECHO 4 years post-diagnosis; annual renal function
  4. 4

    Year 5

    • 6-monthly clinical examination, CXR, plain films of primary site; annual renal function
  5. 5

    Years 6–10

    • Annual clinical examination, CXR, plain films of primary site; MUGA/ECHO 6 years post-diagnosis; annual renal function

Discharge

Discharge at 10 years after surgery unless: Patient has had radiotherapy with toxicity requiring long-term follow-up Patient has a prosthesis in situ (orthopaedic follow-up) Teenage and young adult patients (<25 years at diagnosis) - require long-term late effects service follow-up Clinical trial patients on active follow-up

Bone

Ewing's Sarcoma / Rhabdomyosarcoma - Relapsed Metastatic Disease

Ewing's sarcoma, rhabdomyosarcoma - relapsed or metastatic disease

  1. 1

    Year 1+

    • 2–3 monthly clinical examination and CXR; imaging of disease sites as clinically appropriate
BoneDischarge 10 years

High Grade Osteosarcoma / Spindle Cell Sarcoma of Bone / Dedifferentiated Chondrosarcoma - Localised Post Primary Treatment

High grade osteosarcoma, spindle cell sarcoma of bone, dedifferentiated chondrosarcoma, localised post primary treatment

  1. 1

    Year 1

    • Post-operative visit within first 6 weeks (if primary surgery); 2-monthly clinical examination, CXR, plain films of primary site; annual blood biochemistry (U&E, LFT, Ca, PO4, Mg, HCO3); end of Year 1 - gonadal function (males: testosterone, LH, FSH; females: oestradiol, LH, FSH)
  2. 2

    Years 2–3

    • 3-monthly clinical examination, CXR, plain films of primary site; annual blood biochemistry; end of Year 2 - MUGA or ECHO
  3. 3

    Year 4

    • 6-monthly clinical examination, CXR, plain films of primary site; annual blood biochemistry; end of Year 4 - MUGA or ECHO
  4. 4

    Year 5

    • 6-monthly clinical examination, CXR, plain films of primary site; annual blood biochemistry
  5. 5

    Years 6–10

    • Annual clinical examination, CXR, plain films of primary site; annual blood biochemistry; end of Year 6 - MUGA or ECHO

Discharge

Discharge at 10 years after surgery unless: Patient has had radiotherapy with toxicity requiring long-term follow-up Patient has a prosthesis in situ (follow-up evaluation by orthopaedic team) Teenage and young adult patients (<25 years at diagnosis) - require long-term follow-up in a late effects service Clinical trial patients on active follow-up

BoneDischarge 10 years

High Grade Osteosarcoma / Spindle Cell Sarcoma of Bone - Post Pulmonary Metastatectomy

High grade osteosarcoma, spindle cell sarcoma of bone, dedifferentiated chondrosarcoma - post pulmonary metastatectomy

  1. 1

    Year 1

    • Post-operative visit within first 6 weeks; 3-monthly clinical examination, CXR, plain films of primary site; baseline CT scan post-surgery, then 6-monthly CT scans
  2. 2

    Year 2

    • 3-monthly clinical examination, CXR, plain films of primary site; 6-monthly CT scan
  3. 3

    Years 3–4

    • 6-monthly clinical examination, CXR, plain films of primary site
  4. 4

    Years 5–10

    • Annual clinical examination, CXR, plain films of primary site

Discharge

Discharge at 10 years after surgery

Bone

High Grade Osteosarcoma / Spindle Cell Sarcoma of Bone - Relapsed Metastatic Disease

High grade osteosarcoma, spindle cell sarcoma of bone - relapsed or metastatic disease

  1. 1

    Year 1+

    • 2–3 monthly clinical examination and CXR; imaging of disease sites as clinically appropriate
Soft tissueDischarge 10 years

Soft Tissue Tumours - Abdominal / Retroperitoneal / Gynaecological - Low Grade (Radiologically Directed)

Low grade retroperitoneal sarcoma, gynaecological sarcoma, abdominal sarcoma (excluding GIST)

  1. 1

    Year 1

    • Post-operative visit within first 6 weeks; 3–6 monthly clinical examination; baseline CT chest/abdomen/pelvis post-surgery, then at 6 and 12 months
  2. 2

    Year 2

    • 6-monthly clinical examination; CT chest/abdomen/pelvis at 18 and 24 months
  3. 3

    Year 3+

    • Annual clinical examination; annual CT chest/abdomen/pelvis to 10 years

Discharge

Discharge at 10 years after surgery

Soft tissueDischarge 10 years

Soft Tissue Tumours - Abdominal / Retroperitoneal / Gynaecological - Intermediate and High Grade (Radiologically Directed)

Intermediate and high grade retroperitoneal sarcoma, gynaecological sarcoma, abdominal sarcoma (excluding GIST)

  1. 1

    Year 1

    • Post-operative visit within first 6 weeks; 3-monthly clinical examination and CXR; baseline CT chest/abdomen/pelvis post-surgery, then at 6 and 12 months
  2. 2

    Year 2

    • 3-monthly clinical examination and CXR; CT chest/abdomen/pelvis at 18 and 24 months
  3. 3

    Years 3–4

    • 6-monthly clinical examination and CXR; annual CT chest/abdomen/pelvis
  4. 4

    Years 5–10

    • Annual clinical examination and CXR; annual CT chest/abdomen/pelvis Year 5, then stop

Discharge

Discharge at 10 years after surgery

Soft tissue

Soft Tissue Tumours - Localised Extremity - Benign / Atypical Lipomatous

Benign soft tissue tumours, Atypical lipomatous tumour

  1. 1

    Year 1

    • Post-operative visit within first 6 weeks, then supported discharge
Soft tissueDischarge 10 years

Soft Tissue Tumours - Localised Extremity - Low Grade

Low grade soft tissue sarcoma, localised extremity

  1. 1

    Year 1

    • Post-operative visit within first 6 weeks; 3-month clinical examination (to check function, if necessary); 6-monthly clinical examination and CXR
  2. 2

    Year 2

    • 6-monthly clinical examination and CXR
  3. 3

    Years 3+

    • Annual clinical examination and CXR

Discharge

Discharge at 10 years after surgery

Soft tissueDischarge 10 years

Soft Tissue Tumours - Localised Extremity - Intermediate and High Grade

Intermediate and high grade soft tissue sarcoma, localised extremity

  1. 1

    Year 1

    • Post-operative visit within first 6 weeks; 3–4 monthly clinical examination and CXR; image prosthesis at 6 months and 1 year
  2. 2

    Year 2

    • 3–4 monthly clinical examination and CXR; image prosthesis annually
  3. 3

    Years 3–4

    • 6-monthly clinical examination and CXR; image prosthesis annually
  4. 4

    Years 5–10

    • Annual clinical examination and CXR; image prosthesis annually

Discharge

Discharge at 10 years after surgery unless: Patient has had radiotherapy with toxicity that requires long-term follow-up Patient has a prosthesis in situ (follow-up evaluation by orthopaedic team) Teenage and young adult patients (<25 years at diagnosis) - require long-term follow-up in a late effects service Clinical trial patients on active follow-up

Soft tissue

Soft Tissue Tumours - Locally Advanced or Metastatic Disease

Locally advanced or metastatic soft tissue sarcoma

  1. 1

    Year 1+

    • 3-monthly clinical examination and CXR (or more frequently as clinically indicated); imaging of disease sites as clinically appropriate at clinician's discretion (usually 3-monthly CT scan)
Soft tissueDischarge 10 years

Soft Tissue Tumours - Post Pulmonary Metastatectomy

Soft tissue sarcoma post pulmonary metastatectomy

  1. 1

    Year 1

    • Post-operative visit within first 6 weeks; 3-monthly clinical examination and CXR; baseline CT post-surgery (within 3 months); thereafter 6-monthly CT scans
  2. 2

    Year 2

    • 3-monthly clinical examination and CXR; CT scans at 18 and 24 months
  3. 3

    Years 3–4

    • 6-monthly clinical examination and CXR; continue CT scans at clinician's discretion if felt to be at high risk of recurrence
  4. 4

    Years 5–10

    • Annual clinical examination and CXR

Discharge

Discharge at 10 years after surgery

Soft tissueDischarge 10 years

Soft Tissue Tumours - Head and Neck Sarcomas

Head and neck sarcoma

  1. 1

    Year 1

    • Post-operative visit within first 6 weeks; 3-monthly clinical examination and CXR; post-treatment MRI of primary site at 3 months; surveillance MRI at 9 months
  2. 2

    Year 2

    • 3-monthly clinical examination and CXR; surveillance MRI at 15 and 21 months
  3. 3

    Years 3–4

    • 6-monthly clinical examination and CXR; surveillance MRI at 27 months; thereafter annual MRI of primary site
  4. 4

    Years 5–10

    • Annual clinical examination and CXR

Discharge

Discharge at 10 years after surgery

General

GIST - Metastatic Disease

Gastrointestinal stromal tumour (GIST), metastatic disease

  1. 1

    Years 1–3

    • 3-monthly clinic review and CT chest/abdomen/pelvis
  2. 2

    Year 4 onwards

    • 3-monthly clinic review; 6-monthly CT chest/abdomen/pelvis
GeneralDischarge 10 years

GIST - Post Resection Following Neo-adjuvant Imatinib

Gastrointestinal stromal tumour (GIST), post-resection following neo-adjuvant imatinib

  1. 1
    • As for high risk resected GIST patients
  2. 2

    Years 1–2

    • 3-monthly clinical examination and CT abdomen/pelvis ± CXR
  3. 3

    Years 3–4

    • 6-monthly clinical examination and CT abdomen/pelvis ± CXR
  4. 4

    Years 5–10

    • Annual clinical examination; CT abdomen/pelvis Year 5 only, then stop

Discharge

Discharge at 10 years

GeneralDischarge 10 years

GIST - Post Resection of Localised Disease - High Risk

Gastrointestinal stromal tumour (GIST), high risk post-resection

  1. 1

    Years 1–2

    • 3-monthly clinical examination and CT abdomen/pelvis ± CXR
  2. 2

    Years 3–4

    • 6-monthly clinical examination and CT abdomen/pelvis ± CXR
  3. 3

    Years 5–10

    • Annual clinical examination; annual CT abdomen/pelvis ± CXR Year 5 only, then stop

Discharge

Discharge at 10 years after surgery

GeneralDischarge 5 years

GIST - Post Resection of Localised Disease - Intermediate Risk

Gastrointestinal stromal tumour (GIST), intermediate risk post-resection

  1. 1

    Year 1

    • Baseline CT abdomen/pelvis ± CXR post-surgery and at 6 months
  2. 2

    Years 2–5

    • Annual CT abdomen/pelvis ± CXR

Discharge

Discharge at 5 years from surgery

GeneralDischarge criteria

GIST - Post Resection of Localised Disease - Low Risk

Gastrointestinal stromal tumour (GIST), low risk post-resection

  1. 1

    Year 1

    • CT abdomen/pelvis ± CXR at 12 months post-surgery. Then discharge.

Discharge

Discharge following 12-month scan

GeneralDischarge criteria

GIST - Post Resection of Localised Disease - Very Low Risk

Gastrointestinal stromal tumour (GIST), very low risk post-resection

  1. 1
    • No follow-up required - discharge to primary care

Discharge

Immediate discharge to primary care following surgery

GeneralDischarge 10 years

GIST - Post Resection with Adjuvant Imatinib

Gastrointestinal stromal tumour (GIST), post-resection on adjuvant imatinib

  1. 1

    Years 1–5

    • 6-monthly clinical examination and CT abdomen/pelvis ± CXR
  2. 2

    Years 6–10

    • Annual clinical examination and CT abdomen/pelvis ± CXR

Discharge

Discharge at 10 years after surgery