Detection of local recurrences of limb soft tissue sarcomas: Is magnetic resonance imaging (MRI) relevant?

The role of systematic magnetic resonance imaging (MRI) after resection of soft tissue sarcomas (STS) of the limb is opened to debate. The aim of our study was to retrospectively evaluate the effectiveness of a systematic MRI examination performed in 124 adult patients treated between 1996 and 2006 for a non-metastatic limb STS at our centre: 86 patients (70%) had clear resection margins (R0) and 111 patients (90%) received an adjuvant radiotherapy. Among the 11 local recurrences (9%) which were observed, MRI was able to detect only 2 asymptomatic local recurrences, one with and one without synchronous metastasis. Both had microscopically involved margins (R1). In contrast, MRI showed 11 false positive cases. As the predictive positive value of MRI was 42%, clinical follow-up seems to be more effective.As observed in our study, systematic MRI examination is not relevant for the follow-up of all limb soft tissue sarcomas. A prospective study could be promoted to evaluate the role of MRI in patients at high risk of local recurrence.