<b>Uterine LMS</b>

Uterine LMS tends to recur locally, and to metastasize to the lungs.
There are several "packages" of routine surveillance on offer:  <b>The SARCOMA ONCOLOGIST who is following you should be the actual expert on the most current and cost effective care for you, as are the NCCN guidelines. </b>  

All essentially agree that attention must be paid every three months for the first two years, then every six months for the next three years, then, after 5 years, yearly.

1. Generally in the US, the "attention paid" consists of routine spiral CT scans, with contrast, of chest, abdomen and pelvis. Coupled with the scans are a physical exam, an interim history, and blood and urine tests.  

2. MD Anderson has begun recommending the replacement of routine chest CT with a Chest X Ray, but keeping the rest of the protocol the same.  A chest CT scan would be done before any chemotherapy was given.

3. European standards tend to use Ultrasound of Pelvis and Abdomen instead of routine CT scans of these areas, and routine Chest X-rays, with six monthly CT scans of the chest. 
[The standard monitoring approach in Europe is chest x-ray every three months, with chest CT scan every six months. I was told (though I haven't been able to find a research abstract) that there was no traceable benefit in quarterly chest CT scans. Their reason is that anything which escaped the chest Xray would be so small that doctors would probably leave it to the next scan to see whether it grew if found on a scan.  From Roger]
