Surgical Lymph Node Staging in Extremity Rhabdomyosarcoma: The EpSSG RMS 2005 Trial Experience
Year: 2025
Type: article
Abstract: BACKGROUND: The European pediatric soft tissue Sarcoma Study Group (EpSSG) RMS 2005 study recommends a lymph node biopsy for extremity rhabdomyosarcoma (RMS). The aim of our study was to analyze the results of the lymph node sampling strategies used, such as sentinel node biopsy (SNB) and nodal sampling (NS), and compare the outcome of patients undergoing different nodal staging techniques. METHODS: All non-metastatic (M0) patients registered in the EpSSG RMS 2005 study with an RMS of the extremity, presenting between 2005 and 2016, were included for analysis of the lymph node sampling techniques used. The secondary objective was to compare the results and outcome for the different sampling procedures. RESULTS: Of 198 patients, 144 had clinically/radiologically negative nodes (cN0), and 72/144 underwent a biopsy (26 SNB/46 NS). Final nodal status was upstaged to pN1 in 11/72 (15.3%) patients-6 after SNB and 5 after NS. In 54 radiologically malignant/suspicious-appearing nodes, 34 NS biopsies were performed, resulting in downstaging to N0 in 9/34 (26.5%) patients. 5-years overall survival (OS) of N0 patients versus N1 patients was 82.5% (95% confidence interval CI 74.7-88.0) versus 46.5% (95% CI 32.2-59.7). 5-years OS in N0 patients was not significantly different in biopsied and non-biopsied patients (p = 0.88). However, in N1 patients, survival was significantly better in biopsied compared with non-biopsied patients (p = 0.006). CONCLUSION: Lymph node staging plays a crucial role in determining appropriate treatment strategies. Pathology of sampled lymph nodes can upstage or downstage the lymph node status, guiding treatment decisions based on the stage.
Source: Annals of Surgical Oncology
Authors: Sheila Terwisscha van Scheltinga, Johannes H. M. Merks, Florent Guerin, Timothy Rogers, Ross J. Craigie, Gabriela Guillén, Federica De Corti, Patrizia Dall’Igna, Raquel Dávila Fajardo, Gianni Bisogno, Andrea Ferrari, Daniel Orbach, Meriel Jenney, Julia C. Chisholm, Véronique Minard-Colin, Maya Cesen, Nina Jehanno, Laura S. Hiemcke-Jiwa, Ilaria Zanetti, Beatrice Coppadoro, Alida F. W. van der Steeg, Max M. van Noesel, Marc H. W. A. Wijnen
Institutions: Princess Máxima Center, Utrecht University, University Medical Center Utrecht, Université Paris-Saclay, Assistance Publique – Hôpitaux de Paris, Bicêtre Hospital, University Hospitals Bristol and Weston NHS Foundation Trust, Royal Manchester Children's Hospital, Vall d'Hebron Hospital Universitari, University of Padua, Azienda Ospedale - Università Padova, Fondazione IRCCS Istituto Nazionale dei Tumori, Université Paris Sciences et Lettres, Institut Curie, University Hospital of Wales, Institute of Cancer Research, Royal Marsden Hospital, Institut Gustave Roussy, Fondation Gustave Roussy, Ljubljana University Medical Centre
Language: English
Subfield: Pulmonary and Respiratory Medicine
Field: Medicine
Domain: Health Sciences
Open Access status: hybrid
Estimated APC paid: $4,590
OpenAlex ID: W4412631440