Lay Summary: PET is ocasionally useful in staging sarcoma but not well accepted for restaging. Diagnostic procedures, such as PET scan and CT scan, may help doctors predict a patient’s response to treatment and may help plan the best treatment. Drugs used in chemotherapy, such as doxorubicin and ifosfamide, work in different ways to stop the growth of tumor cells, either by killing the cells or by stopping them from dividing. Giving chemotherapy before surgery may make the tumor smaller and reduce the amount of normal tissue that needs to be removed.Imaging may assist in evaluating a cancer for resection. PET is ocasionally useful in staging sarcoma but not well accepted for restaging. Whether PET/CT is more accurate for staging is not known. NCCN says that PET can be occasionally useful. A recent review says: “In sarcoma, PET scans provide useful complementary information that must be interpreted in the overall context of the patient’s imaging and other evaluations. PET can be used for grading of disease and differentiating between benign and malignant disease, biopsy evaluation, staging and restaging, assessing local recurrence, and therapeutic monitoring. However, further studies are required to improve quantitation of response, because SUVs and TBRs are at best semiquantitative, and comparison among different sites and use in clinical trials will require additional study.”
Positron emission tomography (PET) scanning may be helpful in specific circumstances (e.g., prior to radical amputation following recurrent disease), but cannot at the present time be recommended as a routine staging investigation in patients with STS.1
1.Robert Grimer ET AL, Guidelines for the Management of Soft Tissue Sarcomas. Volume 2010 (2010), Article ID 506182, 15 pages
2.nccn, SARCOMA 2014.
3.Vlker T, Denecke T, Steffen I, et al.: Positron emission tomography for staging of pediatric sarcoma patients: results of a prospective multicenter trial. J Clin Oncol 25 (34): 5435-41, 2007