Sentinel node biopsy in soft tissue sarcoma subtypes with a high propensity for regional lymphatic spread--results of a large prospective trial.
BACKGROUND
The role of sentinel lymph node biopsy (SLNB) in soft tissue sarcoma patients has yet to be determined. We sought to evaluate the role of SLNB in the treatment of patients with clear cell sarcoma (CCS), synovial sarcoma (SS), epithelioid sarcoma (ES) and rhabdomyosarcoma (RMS).


METHODS
Sixty-two consecutive patients without history of regional lymphatic spread or evidence of distant metastases underwent SLNB.


RESULTS
Positive sentinel nodes were identified in 2 out of 42 patients with SS and in 6 out of 12 patients with CCS. Only two CCS patients had further metastatic nodes in regional dissection. Both of these patients, along with another CCS patient, developed distant metastases and ultimately died of disease. The remaining three CCS patients are disease-free in follow-up. One patient with SS and another with ES developed regional lymph node metastases following a negative SLNB, while a further patient with RMS developed distant metastases followed by a local recurrence with regional metastases shortly after.


CONCLUSIONS
SLNB is an important diagnostic tool for patients with CCS, who appear to have a high rate of clinically occult regional lymph node metastases at diagnosis. For SS patients, SLNB appears to be of very little relevance.
Department of Orthopedic Oncology, Sarcoma Center Berlin-Brandenburg, HELIOS Klinikum Berlin-Buch, Berlin. dimosthenis.andreou@googlemail.com
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D
Andreou
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Boldt
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M
Werner
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C
Hamann
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Pink
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Tunn
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D005260:Female; D006801:Humans; D008207:Lymphatic Metastasis / Q000175:diagnosis*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012208:Rhabdomyosarcoma / Q000401:mortality / Q000556:secondary*; D018227:Sarcoma, Clear Cell / Q000401:mortality / Q000556:secondary*; D013584:Sarcoma, Synovial / Q000401:mortality / Q000556:secondary*; D021701:Sentinel Lymph Node Biopsy; D012983:Soft Tissue Neoplasms / Q000401:mortality*; D055815:Young Adult