Skip to main content
NCBI home page
Annals of Surgery logoLink to Annals of Surgery
. 1993 Jan;217(1):72–77. doi: 10.1097/00000658-199301000-00012

Lymph node metastasis from soft tissue sarcoma in adults. Analysis of data from a prospective database of 1772 sarcoma patients.

Y Fong 1, D G Coit 1, J M Woodruff 1, M F Brennan 1
PMCID: PMC1242736  PMID: 8424704

Abstract

To examine the natural history of lymph node metastasis from sarcomas and the utility of therapeutic lymphadenectomy, clinical histories of all adult patients identified by a prospective sarcoma database for the 10-year period July 1982 to July 1991 were examined. Of the 1772 sarcoma patients, 46 (2.6%) were identified with lymph node metastasis. Median follow-up of all patients from diagnosis of lymph node metastasis was 12.9 months (range, 0 to 100 months). Median survival for nonsurvivors was 12.7 months (range, 0 to 40.7). The tumor types with the highest incidence of lymph node metastasis are angiosarcoma (5/37 total cases; 13.5%), embryonal rhabdomyosarcoma (ERMS) (12/88 total cases; 13.6%), and epithelioid sarcoma (2/12 total cases; 16.7%). Lymph node metastasis from visceral primary (p = 0.004) and malignant fibrous histiocytomas (p = 0.006) were associated with particularly poor prognosis. Thirty-one patients underwent radical, therapeutic lymphadenectomy with curative intent, whereas 15 patients had less than curative procedures, in most cases biopsy only. Patients not treated with radical lymphadenectomy had a median survival of 4.3 months (range, 1 to 32) whereas radical lymphadenectomy was associated with a 16.3 month median survival and the only long-term survivors (46% 5-year survival by Kaplan-Meier). The authors conclude that lymph node metastases from sarcoma are rare in adults, but vigilance is warranted, especially in angiosarcoma, ERMS, and epithelioid subtypes. Radical lymphadenectomy is appropriate treatment for isolated metastasis to regional lymph nodes and may provide long-term survival.

Full text

PDF
72

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Bryan R. S., Soule E. H., Dobyns J. H., Pritchard D. J., Linscheid R. L. Primary epithelioid sarcoma of the hand and forearm. A review of thirteen cases. J Bone Joint Surg Am. 1974 Apr;56(3):458–465. [PubMed] [Google Scholar]
  2. Collin C., Godbold J., Hajdu S., Brennan M. Localized extremity soft tissue sarcoma: an analysis of factors affecting survival. J Clin Oncol. 1987 Apr;5(4):601–612. doi: 10.1200/JCO.1987.5.4.601. [DOI] [PubMed] [Google Scholar]
  3. Evans H. L. Alveolar soft-part sarcoma. A study of 13 typical examples and one with a histologically atypical component. Cancer. 1985 Feb 15;55(4):912–917. doi: 10.1002/1097-0142(19850215)55:4<912::aid-cncr2820550434>3.0.co;2-g. [DOI] [PubMed] [Google Scholar]
  4. Gaakeer H. A., Albus-Lutter C. E., Gortzak E., Zoetmulder F. A. Regional lymph node metastases in patients with soft tissue sarcomas of the extremities, what are the therapeutic consequences? Eur J Surg Oncol. 1988 Apr;14(2):151–156. [PubMed] [Google Scholar]
  5. Haagensen C. D., Stout A. P. Synovial Sarcoma. Ann Surg. 1944 Dec;120(6):826–842. doi: 10.1097/00000658-194412000-00003. [DOI] [PMC free article] [PubMed] [Google Scholar]
  6. Hajdu S. I., Shiu M. H., Fortner J. G. Tendosynovial sarcoma: a clinicopathological study of 136 cases. Cancer. 1977 Mar;39(3):1201–1217. doi: 10.1002/1097-0142(197703)39:3<1201::aid-cncr2820390328>3.0.co;2-p. [DOI] [PubMed] [Google Scholar]
  7. Jones E. W. Dowling oration 1976. Malignant vascular tumours. Clin Exp Dermatol. 1976 Dec;1(4):287–312. doi: 10.1111/j.1365-2230.1976.tb01435.x. [DOI] [PubMed] [Google Scholar]
  8. Lawrence W., Jr, Hays D. M., Moon T. E. Lymphatic metastasis with childhood rhabdomyosarcoma. Cancer. 1977 Feb;39(2):556–559. doi: 10.1002/1097-0142(197702)39:2<556::aid-cncr2820390226>3.0.co;2-8. [DOI] [PubMed] [Google Scholar]
  9. Lee Y. T., Moore T. M., Schwinn C. P. Metastasis of sarcomatous lesion in regional lymph node. J Surg Oncol. 1982 May;20(1):53–58. doi: 10.1002/jso.2930200113. [DOI] [PubMed] [Google Scholar]
  10. Maddox J. C., Evans H. L. Angiosarcoma of skin and soft tissue: a study of forty-four cases. Cancer. 1981 Oct 15;48(8):1907–1921. doi: 10.1002/1097-0142(19811015)48:8<1907::aid-cncr2820480832>3.0.co;2-t. [DOI] [PubMed] [Google Scholar]
  11. Mazeron J. J., Suit H. D. Lymph nodes as sites of metastases from sarcomas of soft tissue. Cancer. 1987 Oct 15;60(8):1800–1808. doi: 10.1002/1097-0142(19871015)60:8<1800::aid-cncr2820600822>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  12. Prat J., Woodruff J. M., Marcove R. C. Epithelioid sarcoma: an analysis of 22 cases indicating the prognostic significance of vascular invasion and regional lymph node metastasis. Cancer. 1978 Apr;41(4):1472–1487. doi: 10.1002/1097-0142(197804)41:4<1472::aid-cncr2820410436>3.0.co;2-w. [DOI] [PubMed] [Google Scholar]
  13. Rao R. S., Rao D. N. Prognostic significance of the regional lymph nodes in osteosarcoma. J Surg Oncol. 1977;9(2):123–130. doi: 10.1002/jso.2930090205. [DOI] [PubMed] [Google Scholar]
  14. Ruka W., Emrich L. J., Driscoll D. L., Karakousis C. P. Prognostic significance of lymph node metastasis and bone, major vessel, or nerve involvement in adults with high-grade soft tissue sarcomas. Cancer. 1988 Sep 1;62(5):999–1006. doi: 10.1002/1097-0142(19880901)62:5<999::aid-cncr2820620527>3.0.co;2-n. [DOI] [PubMed] [Google Scholar]
  15. Shiu M. H., Castro E. B., Hajdu S. I., Fortner J. G. Surgical treatment of 297 soft tissue sarcomas of the lower extremity. Ann Surg. 1975 Nov;182(5):597–602. doi: 10.1097/00000658-197511000-00011. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Weingrad D. N., Rosenberg S. A. Early lymphatic spread of osteogenic and soft-tissue sarcomas. Surgery. 1978 Aug;84(2):231–240. [PubMed] [Google Scholar]

Articles from Annals of Surgery are provided here courtesy of Lippincott, Williams, and Wilkins

RESOURCES