Defining the incidence and clinical significance of lymph node metastasis in soft tissue sarcoma

Keung, Emily Z.; Chiang, Yi Ju; Voss, Rachel K.; Cormier, Janice N.; Torres, Keila E.; Hunt, Kelly K.; Feig, Barry W.; Roland, Christina L.

doi:10.1016/j.ejso.2017.11.014

Cited by 87 publications

(85 citation statements)

References 18 publications

(50 reference statements)

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“…For patients with LD, IRS group I and II, primary tumor size ≤5 cm, T1, N0 and best resection R0 and R1 resection were favorable prognostic factors for five-year EFS and OS. Nodal involvement is reported to be present in 13%-21% of adults with ES 42,43. A similar proportion occurred in our cohort of pediatric and adolescent patients with eight of 53 (15%) showing lymph node disease analogous to the published series of 28 children with LD 12.…”

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confidence: 85%

Epithelioid sarcoma in children, adolescents, and young adults: Localized, primary metastatic and relapsed disease. Treatment results of five Cooperative Weichteilsarkom Studiengruppe (CWS) trials and one registry

Sparber‐Sauer

Kościelniak

Vokuhl

et al. 2019

Pediatric Blood & Cancer

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Background Epithelioid sarcoma (ES) is a rare malignant soft‐tissue tumor. Little is known about the optimal treatment of primary localized (LD), metastatic (MD), and relapsed disease (RD). Methods Characteristics, treatment, and outcome of 67 patients registered within the Cooperative Weichteilsarkom Studiengruppe CWS‐81, ‐86, ‐91, ‐96, ‐2002P trials and the registry SoTiSaR were analyzed (1981–2016). Results The median age was 14 years (range, 0.7–26.9); 53 patients had localized disease (LD) and 14 metastatic disease (MD). A total of 58 of 67 patients were treated with primary resection. Resection was microscopically complete (R0) in 35, microscopically incomplete (R1) in 12, macroscopically incomplete (R2) in 20 patients. Radiotherapy (RT) was administered to 33 of 67 patients and 49 of 67 patients received chemotherapy (CHT). Complete remission (CR) was achieved in 45 of 53 (85%) patients with LD. Twenty‐seven of 53 patients relapsed after a median time of 0.9 years (range, 0.1–2.3). Relapse therapy consisted of resection (n = 19/27), RT (n = 10/27), CHT (n = 12/27), and limb perfusion (n = 3/27). The five‐year event‐free survival and overall survival of patients with LD, MD, and RD was 35% (± 12, CI 95%) and 58% (± 14, CI 95%), 7% (± 14, CI 95%), and 9% (± 16, CI 95%), 24% (± 17, CI 95%), and 40% (± 20, CI 95%), respectively. Tumor size, IRS group, tumor invasiveness, nodal status, and best resection correlated with a favorable prognosis in patients with LD while best resection was the only significant factor in patients with RD. Conclusions Complete tumor resection correlates with long‐term survival in patients with ES.

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confidence: 85%

Epithelioid sarcoma in children, adolescents, and young adults: Localized, primary metastatic and relapsed disease. Treatment results of five Cooperative Weichteilsarkom Studiengruppe (CWS) trials and one registry

Sparber‐Sauer

Kościelniak

Vokuhl

et al. 2019

Pediatric Blood & Cancer

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“…It is generally accepted that soft tissue sarcomas arising in the head/neck region have a different natural history than those of other anatomic sites. These tumors are typically smaller and less often associated with distant metastasis at presentation than sarcomas arising at other anatomic sites . In spite of this, patients with head or neck sarcoma tend to fail locally because of the difficulty in obtaining negative surgical resection margins for and delivering adequate levels of ionizing radiation to tumors adjacent to critical regional anatomic structures …”

Section: Discussionmentioning

confidence: 99%

Staging soft tissue sarcoma of the head and neck: Evaluation of the AJCC 8th edition revised T classifications

Cates

2019

Head & Neck

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Background: The American Joint Committee on Cancer (AJCC) has proposed new T classifications for head and neck sarcomas in the 8th edition of the AJCC Cancer Staging Manual, but these classifications have not been evaluated for prognostic utility in tumor staging. Methods: The predictive ability of revised AJCC T classifications was evaluated by nonlinear multivariable regression using records from the Surveillance, Epidemiology, and End Results database (N = 2756). A proposed staging algorithm was developed using a subset of records and compared to the AJCC 7th edition using a separate validation dataset. Results: Categorization of tumor size using revised AJCC 8th edition T classifications accurately reflected the predictive information of this intrinsically continuous variable. A proposed staging system based on revised AJCC T classifications showed significant improvement in clinical performance compared to the previous AJCC 7th edition staging system. Conclusions: Stratifying risk of sarcoma-specific death by categorization of tumor size is informative for head and neck sarcoma. A staging algorithm based on revised AJCC 8th edition T classifications is validated and proposed for further evaluation in staging sarcomas of the head and neck. K E Y W O R D Shead and neck neoplasms, prognosis, SEER program, soft tissue sarcoma, tumor staging

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“…e current study revealed that (1) most LNMs occur earlier than pulmonary metastases and (2) survival from LNM depends on the time duration from primary STS diagnosis to detection of LNM, and an early diagnosis of LNM (<8 months) may predict poor prognosis. e 5-year survival for patients with LNM from STS is reported to be 12.8% to 34.1% [7,9,10]. In our study, the 5year OS was 45.5%.…”

Section: Discussionmentioning

confidence: 45%

“…e potential benefit of lymphadenectomy remains to be defined. Lymphadenectomy has been shown to improve long-term survival [15,16], while radical lymphadenectomy does not confer a substantial survival benefit [9,10]. is study suggests that early LNM (<8 months of duration from the primary tumor diagnosis) may have less impact to decide on an aggressive treatment for LNM.…”

Section: Discussionmentioning

confidence: 98%

“…e overall prevalence is 1.75-12% with an increasing frequency due to the implementation of FDG-PET for whole body screening [7,8]. Regional LNM is an important prognostic factor in STS, suggesting that LNM represents a component of disseminated disease [7,9]. Unlike pulmonary metastasis, the precise role of lymphadenectomy remains to be defined because LNM in patients with STS is rare, thereby limiting the feasibility of well-designed prospective studies to establish the role of lymphadenectomy.…”

Section: Introductionmentioning

confidence: 99%

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Early Lymph Node Metastasis May Predict Poor Prognosis in Soft Tissue Sarcoma

Emori

Tsuchie

Nagasawa

et al. 2019

International Journal of Surgical Oncology

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Background. Lymph node metastasis (LNM) is a relatively rare event in soft tissue sarcoma. An association between the timing of LNM detection and patient prognosis is presently unknown. Patients and Methods. We retrospectively analyzed the clinicopathological features of 33 patients with LNM between 2001 and 2015. Analysis of the timing of LNM diagnosis was grouped according to patients presenting LNM in either <8 months (the median time from primary tumor diagnosis to LNM) or ≥8 months after primary tumor diagnosis. Results. A relationship between the primary tumor size and the timing of the LNM was not significantly found (Rs = 0.0088, p=0.96). Sixteen patients had an LNM detection duration of <8 months, and 17 patients had a duration of ≥8 months. The 5-year survival for patients with an LNM detection duration of <8 months and ≥8 months was 19% and 71%, respectively (p=0.0016). There were 19 patients with pulmonary metastases. Among them, there were 13 patients with a duration of primary tumor diagnosis to LNM of <8 months and 6 with a duration of ≥8 months (p=0.01). Conclusion. Early LNM (<8 months) may predict poor prognosis in soft tissue sarcoma.

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Defining the incidence and clinical significance of lymph node metastasis in soft tissue sarcoma

Cited by 87 publications

References 18 publications

Epithelioid sarcoma in children, adolescents, and young adults: Localized, primary metastatic and relapsed disease. Treatment results of five Cooperative Weichteilsarkom Studiengruppe (CWS) trials and one registry

Epithelioid sarcoma in children, adolescents, and young adults: Localized, primary metastatic and relapsed disease. Treatment results of five Cooperative Weichteilsarkom Studiengruppe (CWS) trials and one registry

Staging soft tissue sarcoma of the head and neck: Evaluation of the AJCC 8th edition revised T classifications

Early Lymph Node Metastasis May Predict Poor Prognosis in Soft Tissue Sarcoma

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