Efficacy and Cost-Benefit Analysis of Magnetic Resonance Imaging in the Follow-Up of Soft Tissue Sarcomas of the Extremities and Trunk

There is no consensus regarding follow-up after soft tissue sarcoma (STS) treatment. This study examines the efficacy and the cost-benefit of MRI imaging for discovering recurrence. A retrospective analysis was performed, collecting data on patient demography, tumor characteristics, treatment, and follow-up. Imaging was correlated to the clinical course, and sensitivity, specificity, and predictive values were calculated. The number needed to screen and costs of finding recurrence are reported. Amongst 216 sarcomas, 73 (35%) exhibited local recurrence during a follow-up of 5.3 ± 3.5 years. 173 entities had complete MRI follow-up with 58 (34%) local recurrences. Thirty-three (57%) were discovered by MRI, 8 (14%) by clinical presentation, and 17 (29%) simultaneously. There was a sensitivity of 100.00%, a specificity of 89%, a positive predictive value of 32%, and a negative predictive value of 100% for detecting local recurrence with MRI. Our data confirm the modalities and intervals proposed by the German guidelines for sarcoma care. The recommended MRI intervals should not be extended. MRI is more cost-effective than clinical examination; still, both modalities should be performed together to discover the maximum number of recurrences

Educational family background and the realisation of educational career intentions: participation of German upper secondary graduates in higher education over time

In this article, we evaluate the impact of social origin on the realisation of educational intentions at the time of becoming eligible for higher education in Germany. In general, we find high persistence of intentions and actual attendance of higher education. However, effects of parental education on the changes of educational intentions increase the existing social inequality with regard to higher education at the time of leaving secondary school. The group which is affected most are those young adults planning to study after vocational training—while the gap between different origin groups does not widen much during other stop-outs from education. This can be explained only partly by previous educational performance. The findings suggest that estimates of educational inequality are attenuated when entry into higher education is approximated by educational intentions of young adults