Prognostic significance of lymph node metastasis of soft tissue sarcoma of the extremities. National cancer institute experience.

IF 2.4 3区医学 Q3 ONCOLOGY

International Journal of Clinical Oncology Pub Date : 2025-02-01 Epub Date: 2024-12-19 DOI:10.1007/s10147-024-02674-1

Mohamed Shalaby, Rasha M Allam, Mohamed A Elkordy, Mohammad Taher

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引用次数: 0

Abstract

Background and objective: Lymph node metastasis (LNM) in soft tissue sarcoma (STS) of the extremities is relatively rare. We aimed to evaluate the prognosis and the survival of patients with LNM and correlate them to the pattern of metastasis.

Methods: A retrospective study of patients diagnosed with STS of the extremities from 2015 to 2019.

Results: 111/1506 patients (7.4%) had LNM. Nodal metastasis was correlated significantly with old age, advanced tumor stages, high-grade tumors, presence of Lymphovascular invasion (LVI), and resection margins < = 2 cm. Metachronous LNM was documented in 96 patients (86.5%) and synchronous LNM in 15 patients (13.5%). The 6-year overall survival (OS) was 36.3% for those with LNM and 52.9% for those without LNM. The 6-year disease-free survival (DFS) was 5.7% for those with LNM and 32.6% for those without LNM. Metachronus pattern of LNM showed a significantly poorer outcome regarding 6-year OS and DFS than the synchronous pattern.

Conclusions: LNM significantly negatively predicts OS and DFS in the extremities' STS. In particular, the metachronous pattern of LNM indicates a grave prognosis as these patients are supposed to harbor an occult LNM at presentation and were not subjected to lymphadenectomy at their initial primary treatment surgery. Therefore, seeking a valid noninvasive diagnostic tool such as sentinel lymph node biopsy to detect nodal metastasis is necessary.

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四肢软组织肉瘤淋巴结转移的预后意义。国家癌症研究所的工作经验。

背景与目的：四肢软组织肉瘤（STS）的淋巴结转移（LNM）相对罕见。我们的目的是评估LNM患者的预后和生存，并将其与转移模式联系起来。方法：对2015 - 2019年诊断为四肢STS的患者进行回顾性研究。结果：1506例患者中有111例（7.4%）发生LNM。淋巴结转移与年龄、肿瘤分期、肿瘤级别、是否存在淋巴血管侵犯（LVI）和切除边缘相关。结论：LNM与四肢STS的OS和DFS呈显著负相关。特别是，异时性淋巴结转移模式预示着严重的预后，因为这些患者在出现时被认为是隐匿性淋巴结转移，并且在最初的初级治疗手术中没有进行淋巴结切除术。因此，寻找一种有效的无创诊断工具，如前哨淋巴结活检来检测淋巴结转移是必要的。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Clinical Oncology 医学-肿瘤学

CiteScore

6.80

自引率

3.00%

发文量

175

审稿时长

2 months

期刊介绍： The International Journal of Clinical Oncology (IJCO) welcomes original research papers on all aspects of clinical oncology that report the results of novel and timely investigations. Reports on clinical trials are encouraged. Experimental studies will also be accepted if they have obvious relevance to clinical oncology. Membership in the Japan Society of Clinical Oncology is not a prerequisite for submission to the journal. Papers are received on the understanding that: their contents have not been published in whole or in part elsewhere; that they are subject to peer review by at least two referees and the Editors, and to editorial revision of the language and contents; and that the Editors are responsible for their acceptance, rejection, and order of publication.