Abstract
Background
The impact of lymph node metastases on survival in extremity soft tissue sarcomas has been studied for a long time with controversial results. The purpose of this study was to compare survival of patients with initial lymph node metastases with those having lymph node or distant metastases or both after initial curative surgery.
Methods
Patients treated between 1995 and 2000 for extremity soft tissue sarcoma were retrospectively studied in four groups: those with metastatic regional lymph nodes at the time of diagnosis, those with only regional lymph node recurrences, those with only distant metastatic relapses, and those with both regional lymph node recurrences and distant metastatic relapses, all of the last three groups after initial curative surgery. The impact of timing of lymph node metastases on disease-free and overall survival was evaluated.
Results
A total of 110 patients (73 men) with a median age of 45 years were eligible for the study. Three-year disease-free survival was significantly longer in patients with initial regional lymph node metastases than in patients with only lymph node recurrences after curative surgery (p = 0.04) and patients with initial (p = 0.0002) and recurrent (p = 0.0004) regional lymph node metastases had longer disease-free survival than patients with distant metastases. Overall survival difference between patients with initial regional lymph node metastases and patients with only lymph node recurrences after curative surgery was significant at 5 years (p = 0.01).
Conclusions
It is logical to separate patients with initial lymph node metastases from those with distant metastases in staging and to treat patients with initial lymph node metastases with radical surgical interventions if complete tumor resection seems feasible.
This is a preview of subscription content, log in via an institution to check access.
Similar content being viewed by others
References
Fong Y, Coit DG, Woodruff JM, et al. (1993) Lymph node metastasis from soft tissue sarcoma in adults: analysis of data from a prospective database of 1772 sarcoma patients. Ann Surg 217:72–77
Mazeron JJ, Suit HD (1987) Lymph nodes as sites of metastases from sarcomas of soft tissue. Cancer 60:1800–1808
Riad S, Griffin AM, Liberman B, et al. (2004) Lymph node metastasis in soft tissue sarcoma in an extremity. Clin Orthop Relat Res 426:129–134
Vezeridis MP, Moore R, Karakousis CP (1983) Metastatic patterns in soft tissue sarcomas. Arch Surg 118:915–918
Behranwala KA, A’Hern R, Omar AM, et al. (2004) Prognosis of lymph node metastasis in soft tissue sarcoma. Ann Surg Oncol 11:714–719
Gaakeer HA, Albus-Lutter CE, Gortzak E, et al. (1988) Regional lymph node metastases in patients with soft tissue sarcomas of the extremities, what are the therapeutic consequences? Eur J Surg Oncol 14:151–156
Weingrad DN, Rosenberg SA (1978) Early lymphatic spread of osteogenic and soft tissue sarcomas. Surgery 84:231–240
Greene FL, Page DL, Balch CM, et al. (2002) AJCC Cancer Staging Manual, 6th Edition, New York, Springer-Verlag
Sobin LH, Wittekind C, Henson DE, International Union Against Cancer (UICC) (2002) TNM Classification of Malignant Tumours, 6th Edition, New York, Wiley-Liss
Khirwadkar N, Dey P, Das A, et al. (2001) Fine-needle aspiration biopsy of metastatic soft-tissue sarcomas to lymph nodes. Diagn Cytopathol 24:229–232
Blazer DG III, Sabel MS, Sondak VK (2003) Is there a role for sentinel lymph node biopsy in the management of sarcoma? Surg Oncol 12:201–206
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Atalay, C., Altinok, M. & Seref, B. The Impact of Lymph Node Metastases on Survival in Extremity Soft Tissue Sarcomas. World J Surg 31, 1433–1437 (2007). https://doi.org/10.1007/s00268-007-9078-3
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s00268-007-9078-3