Abstract
While regional lymphatic spread develops in only 3%–4% of all patients with soft tissue sarcoma, there are several histological subtypes associated with a significantly higher propensity for regional lymph node metastasis. These include clear cell sarcoma, synovial sarcoma, rhabdomy-osarcoma, and epithelioid sarcoma. To date there is no validated, noninvasive method to assess regional lymph node status. A potentially useful diagnostic tool is lymphatic mapping with sentinel lymph node biopsy, a concept that has revolutionized the treatment of patients with intermediate thickness melanoma and early stage breast cancer. The purpose of this study is to provide an overview of the procedure of sentinel lymph node biopsy and the data available on its application in patients with soft tissue sarcomas.
This is a preview of subscription content, log in via an institution.
Buying options
Tax calculation will be finalised at checkout
Purchases are for personal use only
Learn about institutional subscriptionsPreview
Unable to display preview. Download preview PDF.
References
Al-Refaie WB, Ali MW, Chu DZ, Paz IB, Blair SL (2004) Clear cell sarcoma in the era of sentinel lymph node mapping. J Surg Oncol 87:126–129
Albertini JJ, Cruse C W, Rapaport D, Wells K, Ross M, DeConti R, Berman CG, Jared K, Messina J, Lyman G, Glass F, Fenske N, Reintgen DS (1996) Intraoperative radio-lympho-scintig raphy improves sentinel lymph node identification for patients with melanoma. Ann Surg 223:217–224
Albores-Zúñiga O, Padilla-Rosciano AE, Martýnez-Said H, Cuéllar-Hubbe M, Ramírez-Bollas J (2006) Clear cell sarcoma and sentinel lymph node biopsy. Case report and literature review. Cir Cir 74:121–125
Alex JC, Weaver DL, Fairbank JT, Rankin BS, Krag DN (1993) Gamma-probe-guided lymph node localization in malignant melanoma. Surg Oncol 2:303–308
Andrassy RJ, Okcu MF, Despa S, Raney RB (2001) Synovial sarcoma in children: surgical lessons from a single institution and review of the literature. J Am Coll Surg 192:305–313
Ariel IM (1988) Incidence of metastases to lymph nodes from soft-tissue sarcomas. Semin Surg Oncol 4:27–29
Baratti D, Pennacchioli E, Casali PG, Bertulli R, Lozza L, Olmi P, Collini P, Radaelli S, Fiore M, Gronchi A (2007) Epithelioid sarcoma: prognostic factors and survival in a series of patients treated at a single institution. Ann Surg Oncol 14:3542–3551
Behranwala KA, A'Hern R, Omar AM, Thomas JM (2004) Prognosis of lymph node metastasis in soft tissue sarcoma. Ann Surg Oncol 11:714–719
Bilchik AJ, DiNome M, Saha S, Turner RR, Wiese D, McCarter M, Hoon DS, Morton DL (2006) Prospective multicenter trial of staging adequacy in colon cancer: preliminary results. Arch Surg 141:527–533
Billingsley KG, Burt ME, Jara E, Ginsberg RJ, Woodruff JM, Leung DH, Brennan MF (1999) Pulmonary metastases from soft tissue sarcoma: analysis of patterns of diseases and postmetastasis survival. Ann Surg 229:602–610
Blazer DG 3rd, Sabel MS, Sondak VK (2003) Is there a role for sentinel lymph node biopsy in the management of sarcoma? Surg Oncol 12:201–206
Bos GD, Pritchard DJ, Reiman HM, Dobyns JH, Ilstrup DM, Landon GC (1988) Epithelioid sarcoma. An analysis of fifty-one cases. J Bone Joint Surg Am 70:862–870
Bostick P, Essner R, Glass E, Kelley M, Sarantou T, Foshag LJ, Qi K, Morton D (1999) Comparison of blue dye and probe-assisted intraoperative lymphatic mapping in melanoma to identify sentinel nodes in 100 lymphatic basins. Arch Surg 134:43–49
Cochran AJ, Balda BR, Starz H, Bachter D, Krag DN, Cruse CW, Pijpers R, Morton DL (2000) The Augsburg Consensus. Techniques of lymphatic mapping, sentinel lymphadenectomy, and completion lymphadenectomy in cutaneous malignancies. Cancer 89:236–241
Cook MG, Green MA, Anderson B, et al (2003) The development of optimal pathological assessment of sentinel lymph nodes for melanoma. J Pathol 200:314–319
Cserni G, Amendoeira I, Apostolikas N, et al (2003) Pathological work-up of sentinel lymph nodes in breast cancer. Review of current data to be considered for the formulation of guidelines. Eur J Cancer 39:1654–1667
de Visscher SA, van Ginkel RJ, Wobbes T, Veth R P, Ten Heuvel SE, Suurmeijer AJ, Hoekstra HJ (2006) Epithelioid sarcoma: still an only surgically curable disease. Cancer 107:606–612
Deenik W, Mooi WJ, Rutgers EJ, Peterse JL, Hart AA, Kroon BB (1999) Clear cell sarcoma (malignant melanoma) of soft parts: a clinicopathologic study of 30 cases. Cancer 86:969–975
Eckardt JJ, Pritchard DJ, Soule EH (1983) Clear cell sarcoma. A clinicopathologic study of 27 cases. Cancer 52:1482–1488
Esnaola NF, Rubin B P, Baldini EH, Vasudevan N, Demetri GD, Fletcher CD, Singer S (2001) Response to chemotherapy and predictors of survival in adult rhabdomyosarcoma. Ann Surg 234:215–223
Estourgie SH, Nieweg OE, Valdés Olmos RA, Hoefnagel CA, Kroon BB (2003) Review and evaluation of sentinel node procedures in 250 melanoma patients with a median follow-up of 6 years. Ann Surg Oncol 10:681–688
Fantini F, Monari P, Bassissi S, Maiorana A, Cesinaro A (2007) Sentinel lymph node biopsy in clear cell sarcoma. J Eur Acad Dermatol Venereol 21:1271–1272
Ferrari A, Gronchi A, Casanova M, Meazza C, Gandola L, Collini P, Lozza L, Bertulli R, Olmi P, Casali PG (2004) Synovial sarcoma: a retrospective analysis of 271 patients of all ages treated at a single institution. Cancer 101:627–634
Fong Y, Coit DG, Woodruff JM, Brennan MF (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
Gadd MA, Casper ES, Woodruff JM, McCormack PM, Brennan MF (1993) Development and treatment of pulmonary metastases in adult patients with extremity soft tissue sarcoma. Ann Surg 218:705–712
Ham SJ, van der Graaf WT, Pras E, Molenaar WM, van den Berg E, Hoekstra HJ (1998) Soft tissue sarcoma of the extremities. A multimodality diagnostic and therapeutic approach. Cancer Treat Rev 24:373–391
Hawkins WG, Hoos A, Antonescu CR, Urist MJ, Leung DH, Gold JS, Woodruff JM, Lewis JJ, Brennan MF (2001) Clinicopathologic analysis of patients with adult rhabdomyosarcoma. Cancer 91:794–803
Jemal A, Siegel R, Ward E, Murray T, Xu J, Thun MJ (2007) Cancer statistics, 2007. CA Cancer J Clin 57:43–66
Kotilingam D, Lev DC, Lazar AJ, Pollock RE (2006) Staging soft tissue sarcoma: evolution and change. CA Cancer J Clin 56:282–291
Kuiper DR, Hoekstra HJ, Veth R P, Wobbes T (2003) The management of clear cell sarcoma. Eur J Surg Oncol 29:568–570
Lawrence W Jr, Hays DM, Heyn R, Tefft M, Crist W, Beltangady M, Newton W Jr, Wharam M (1987) Lymphatic metastases with childhood rhabdomy-osarcoma. A report from the Intergroup Rhabdomyosarcoma Study. Cancer 60:910–915
Leong SP, Cady B, Jablons DM, Garcia-Aguilar J, Reintgen D, Jakub J, Pendas S, Duhaime L, Cassell R, Gardner M, Giuliano R, Archie V, Calvin D, Mensha L, Shivers S, Cox C, Werner JA, Kitagawa Y, Kitajima M (2006) Clinical patterns of metastasis. Cancer Metastasis Rev 25:221–232
Little DJ, Ballo MT, Zagars GK, Pisters P W, Patel SR, El-Naggar AK, Garden AS, Benjamin RS (2002) Adult rhabdomyosarcoma: outcome following multimodality treatment. Cancer 95:377–388
Mark RJ, Poen JC, Tran LM, Fu YS, Juillard GF (1996) Angiosarcoma. A report of 67 patients and a review of the literature. Cancer 77:2400–2406
Mazeron JJ, Suit HD (1987) Lymph nodes as sites of metastases from sarcomas of soft tissue. Cancer 60:1800–1808
McMasters KM, Tuttle TM, Carlson DJ, Brown CM, Noyes RD, Glaser RL, Vennekotter DJ, Turk PS, Tate PS, Sardi A, Cerrito PB, Edwards MJ (2000) Sentinel lymph node biopsy for breast cancer: a suitable alternative to routine axillary dissection in multi-institutional practice when optimal technique is used. J Clin Oncol 18:2560–2566
McMasters KM, Noyes RD, Reintgen DS, et al (2004) Lessons learned from the Sunbelt Melanoma Trial. J Surg Oncol 86:212–223
McMulkin HM, Yanchar NL, Fernandez CV, Giacomantonio C (2003) Sentinel lymph node mapping and biopsy: a potentially valuable tool in the management of childhood extremity rhab-domyosarcoma. Pediatr Surg Int 19:453–456
Micheli A, Mugno E, Krogh V, et al (2002) Cancer prevalence in European registry areas. Ann Oncol 13:840–865
Morton D, Cagle L, Wong J, et al (1990) Intraoperative lymphatic mapping and selective lymphadenec-tomy: technical details of a new procedure for clinical stage I melanoma. Presented at the Annual Meeting of the Society of Surgical Oncology. Washington DC
Morton DL, Wen DR, Wong JH, Economou JS, Cagle LA, Storm FK, Foshag LJ, Cochran AJ (1992) Technical details of intraoperative lymphatic mapping for early stage melanoma. Arch Surg 127:392–399
Morton DL, Thompson JF, Essner R, Elashoff R, Stern SL, Nieweg OE, Roses DF, Karakousis CP, Mozzillo N, Reintgen D, Wang HJ, Glass EC, Cochran AJ (1999) Validation of the accuracy of intraoperative lymphatic mapping and sentinel lymphadenectomy for early-stage melanoma: a multicenter trial. Multicenter Selective Lympha-denectomy Trial Group. Ann Surg 230:453–463
Morton DL, Cochran AJ, Thompson JF, et al (2005) Sentinel node biopsy for early-stage melanoma: accuracy and morbidity in MSLT-I, an international multicenter trial. Ann Surg 242:302–311
Naik AM, Fey J, Gemignani M, Heerdt A, Montgomery L, Petrek J, Port E, Sacchini V, Sclafani L, VanZee K, Wagman R, Borgen PI, Cody HS 3rd (2004) The risk of axillary relapse after sentinel lymph node biopsy for breast cancer is comparable with that of axillary lymph node dissection: a follow-up study of 4008 procedures. Ann Surg 240:462–468
Neville HL, Andrassy RJ, Lally KP, Corpron C, Ross MI (2000a) Lymphatic mapping with sentinel node biopsy in pediatric patients. J Pediatr Surg 35:961–964
Neville HL, Andrassy RJ, Lobe TE, Bagwell CE, Anderson JR, Womer RB, Crist WM, Wiener ES (2000b) Preoperative staging, prognostic factors, and outcome for extremity rhabdomyosarcoma: a preliminary report from the Intergroup Rhabdo-myosarcoma Study IV (1991–1997). J Pediatr Surg 35:317–321
Neville HL, Raney RB, Andrassy RJ, Cooley DA (2000c) Multidisciplinary management of pediat-ric soft-tissue sarcoma. Oncology 14:1471–1481
Nieweg OE, Tanis PJ, Kroon BB (2001) The definition of a sentinel node. Ann Surg Oncol 8:538–541
Nishida Y, Yamada Y, Tsukushi S, Shibata S, Ishiguro N (2005) Sentinel lymph node biopsy reveals a positive popliteal node in clear cell sarcoma. Anticancer Res 25:4413–4416
Okcu MF, Munsell M, Treuner J, Mattke A, Pappo A, Cain A, Ferrari A, Casanova M, Ozkan A, Raney B (2003) Synovial sarcoma of childhood and adolescence: a multicenter, multivariate analysis of outcome. J Clin Oncol 21:1602–1611
Picciotto F, Zaccagna A, Derosa G, Pisacane A, Puiatti P, Colombo E, Dardano F, Ottinetti A (2005) Clear cell sarcoma (malignant melanoma of soft parts) and sentinel lymph node biopsy. Eur J Dermatol 15:46–48
Potter DA, Glenn J, Kinsella T, Glatstein E, Lack EE, Restrepo C, White DE, Seipp CA, Wesley R, Rosenberg SA (1985) Patterns of recurrence in patients with high-grade soft-tissue sarcomas. J Clin Oncol 3:353–366
Riad S, Griffin AM, Liberman B, Blackstein ME, Catton CN, Kandel RA, O'Sullivan B, White LM, Bell RS, Ferguson PC, Wunder JS (2004) Lymph node metastasis in soft tissue sarcoma in an extremity. Clin Orthop Relat Res 129–134
Ruka W, Emrich LJ, Driscoll DL, Karakousis CP (1988) Prognostic significance of lymph node metastasis and bone, major vessel, or nerve involvement in adults with high-grade soft tissue sarcomas. Cancer 62:999–1006
Rydholm A, Berg NO, Gullberg B, Thorngren KG, Persson BM (1984) Epidemiology of soft-tissue sarcoma in the locomotor system. A retrospective population-based study of the inter-relationships between clinical and morphologic variables. Acta Pathol Microbiol Immunol Scand 92:363–374
Seal A, Tse R, Wehrli B, Hammond A, Temple CL (2005) Sentinel node biopsy as an adjunct to limb salvage surgery for epithelioid sarcoma of the hand. World J Surg Oncol 3:41
Skinner KA, Eilber FR (1996) Soft tissue sarcoma nodal metastases: biologic significance and therapeutic considerations. Surg Oncol Clin N Am 5:121–127
Spillane AJ, Thomas JM, Fisher C (2000) Epithelioid sarcoma: the clinicopathological complexities of this rare soft tissue sarcoma. Ann Surg Oncol 7:218–225
Spurrell EL, Fisher C, Thomas JM, Judson IR (2005) Prognostic factors in advanced synovial sarcoma: an analysis of 104 patients treated at the Royal Marsden Hospital. Ann Oncol 16:437–444
Takeuchi H, Morton DL, Kuo C, Turner RR, Elashoff D, Elashoff R, Taback B, Fujimoto A, Hoon DS (2004) Prognostic significance of molecular upstaging of paraffin-embedded sentinel lymph nodes in melanoma patients. J Clin Oncol 22:2671–2680
Tunn PU, Andreou D, Illing H, Fleige B, Dresel S, Schlag PM (2007) Sentinel node biopsy in syno-vial sarcoma. Eur J Surg Oncol doi:10.1016/j. ejso.2007.07.014
van Akkooi AC, Verhoef C, van Geel AN, Kliffen M, Eggermont AM, de Wilt JH (2006) Sentinel node biopsy for clear cell sarcoma. Eur J Surg Oncol 32:996–999
van der Veen H, Hoekstra OS, Paul MA, Cuesta MA, Meijer S (1994) Gamma probe-guided sentinel node biopsy to select patients with melanoma for lymphadenectomy. Br J Surg 81:1769–1770
Weingrad DN, Rosenberg SA (1978) Early lymphatic spread of osteogenic and soft-tissue sarcomas. Surgery 84:231–240
Wharam MD, Meza J, Anderson J, Breneman JC, Donaldson SS, Fitzgerald TJ, Michalski J, Teot LA, Wiener ES, Meyer WH (2004) Failure pattern and factors predictive of local failure in rhabdomyosarcoma: a report of group III patients on the third Intergroup Rhabdomyosarcoma Study. J Clin Oncol 22:1902–1908
Author information
Authors and Affiliations
Editor information
Editors and Affiliations
Rights and permissions
Copyright information
© 2009 Springer-Verlag Berlin Heidelberg
About this chapter
Cite this chapter
Andreou, D., Tunn, PU. (2009). Sentinel Node Biopsy in Soft Tissue Sarcome. In: Tunn, PU. (eds) Treatment of Bone and Soft Tissue Sarcomas. Recent Results in Cancer Research, vol 179. Springer, Berlin, Heidelberg. https://doi.org/10.1007/978-3-540-77960-5_3
Download citation
DOI: https://doi.org/10.1007/978-3-540-77960-5_3
Publisher Name: Springer, Berlin, Heidelberg
Print ISBN: 978-3-540-77959-9
Online ISBN: 978-3-540-77960-5
eBook Packages: MedicineMedicine (R0)