Prognosis of lymph node metastasis in extremity soft tissue sarcoma poor

The 5-year disease-specific survival (DSS) for patients with regional lymph node metastasis (RLNM) in historically high-risk extremity soft tissue sarcomas (STSs) is 26%, according to a study.

In this retrospective review of data from the Surveillance, Epidemiology, and End Results database, RLNM was found in 3.7% of patients with extremity STS. Rhabdomyosarcoma, clear cell sarcoma, epithelioid sarcoma, angiosarcoma, spindle cell sarcoma, and synovial sarcoma had the highest rate of RLNM with 26.7%, 18.8%, 14.5%, 8.1%, 5%, and 3.2%, respectively.

When RLNM was not present, the 5-year DSS probability was 69% compared to 26% when RLNM was present. Older age, higher grade tumors, tumor size >10 cm, primary site surgery, distant metastasis, and RLNM were each independent disease-specific prognostic factors for historically high-risk extremity STS.

The authors concluded that a staging system of STS that includes nodal involvement should be considered.

Reference
Gusho CA, Fice MP, O’Donoghue CM, et al. A population-based analysis of lymph node metastasis in extremity soft tissue sarcoma: An update. J Surg Res. 2021;262:121-129. DOI: 10.1016/j.jss.2021.01.005. Epub ahead of print. PMID: 33561723.