4.7 Article Proceedings Paper

Lymph node metastases in paediatric and young adult patients with non-rhabdomyosarcoma soft tissue sarcoma (NRSTS): Findings from Children?s Oncology Group (COG) study ARST0332

Journal

EUROPEAN JOURNAL OF CANCER
Volume 180, Issue -, Pages 89-98

Publisher

ELSEVIER SCI LTD
DOI: 10.1016/j.ejca.2022.11.014

Keywords

Paediatric; Non-rhabdomyosarcoma soft tissue sarcoma (NRSTS); Lymph node metastases; Prognostic factor

Categories

Ask authors/readers for more resources

The aim of this study is to define the clinical features and outcomes of young patients with NRSTS with LN metastases. LN metastases occur in about 4% of paediatric/young adult NRSTS patients, are limited to a few histologic subtypes, and are rare in patients without clinical or imaging evidence of lymphadenopathy. Therefore, biopsies of non-enlarged LNs are not necessary to identify occult involvement.
Purpose: The aim of this paper is to better define the clinical features and outcomes of young patients with non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) with regional and distant lymph node (LN) metastases treated in a standardised fashion, we analysed LN involvement in COG study ARST0332, which evaluated a risk-based treatment strategy for young patients with all stages of NRSTS.Patients and methods: Patients <30 years old with newly diagnosed NRSTS and LN metasta-ses enrolled on ARST0332 were studied. Regional LN sampling was required for those with epithelioid sarcoma, clear cell sarcoma or clinically/radiographically enlarged LNs. Tumour features and extent of pre-enrolment resection determined treatment, including chemotherapy, radiotherapy, and delayed surgery. Recommendations for LN metastases included LN dissec-tion at the time of primary tumour resection and dose-adapted radiotherapy based on extent of LN resection.Results: Twenty of 529 eligible and evaluable ARST0332 patients with NRSTS had LN me-tastases; epithelioid sarcoma had the highest incidence (18%, 5 of 28). Pre-treatment imaging identified LN enlargement in 19 of 20 patients; 1 had no pre-treatment LN imaging. At 6.9 years median follow-up for surviving patients, 5-year overall survival was 85.7% (95% CI: 33.4%, 97.9%) for seven patients with isolated LN metastases and 15.4% (95% CI: 2.5%, 38.8%) for 13 patients with additional extranodal metastases. LN recurrence occurred in only one patient without LNs sampled at initial diagnosis.Conclusion: LN metastases occur in about 4% of paediatric/young adult NRSTS, are limited to a few histologic subtypes, and are rare in patients who did not have clinical or imaging ev-idence of lymphadenopathy, suggesting that biopsies of non-enlarged LNs are not necessary to identify occult involvement. Patients with isolated LN metastases have high 5-year overall sur-vival (w85%) and should be treated with curative intent.Clinicaltrials.gov Registry No.: NCT00346164. 2022 Elsevier Ltd. All rights reserved.

Authors

I am an author on this paper
Click your name to claim this paper and add it to your profile.

Reviews

Primary Rating

4.7
Not enough ratings

Secondary Ratings

Novelty
-
Significance
-
Scientific rigor
-
Rate this paper

Recommended

No Data Available
No Data Available