Prognosis of lymph node metastasis in soft tissue sarcoma

Background: We defined the tumor characteristics and prognosis of patients with regional lymph node metastasis (RLNM) from soft tissue sarcoma.

Methods: All patients with RLNM from soft tissue sarcoma were identified from the Royal Marsden Hospital Sarcoma Unit prospective database from January 1990.

Results: A total of 73 (3.4%) of 2127 patients had RLNM. Fifty-seven patients (78.1%) had RLNM as the first site of spread, and 16 patients (21.9%) presented with RLNM and distant metastasis synchronously. The most common histologies were rhabdomyosarcoma, epithelioid sarcoma, and angiosarcoma. There were 9 T1 and 36 T2 tumors, and tumor size was not available in 28 patients. There were 6 grade 1, 16 grade 2, and 51 grade 3 tumors. Forty-two patients presented with RLNM along with the primary tumor. Of the remaining patients, the median time to development of RLNM from diagnosis of the primary tumor was 13.5 months (95% confidence interval [CI], 1–100 months). The 1-year survival for patients with isolated RLNM was 77.49% (95% CI, 62.99%–86.88%), compared with 36.27% (95% CI, 13.32%–60.04%) for patients who presented with RLNM and distant metastasis (P = .005). The 1-year survival for metachronous and synchronous RLNM was 94.44% (95% CI, 66.64%–99.20%) and 67.54% (95% CI, 47.89%–81.12%), respectively (P = .05).

Conclusions: Lymph node metastasis is rare. Patients who present with isolated RLNM have an improved survival compared with patients who present with regional and distant metastasis at diagnosis. Synchronous RLNM with the primary tumor have a poorer outcome than metachronous RLNM in the absence of distant metastasis.

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Author informationAuthors and Affiliations

Sarcoma and Melanoma Unit, Royal Marsden NHS Trust, United Kingdom

Kasim A. Behranwala MS, DNB, FRCS (Ed), FRCS (Glas), Roger A’Hern MSc, Al-Muderis Omar BSc & J. Meirion Thomas MS, FRCS, FRCP

Sarcoma and Melanoma Unit, Royal Marsden NHS Trust, 203 Fulham Road, London, SW3 6JJ, UK

Kasim A. Behranwala MS, DNB, FRCS (Ed), FRCS (Glas)

AuthorsKasim A. Behranwala MS, DNB, FRCS (Ed), FRCS (Glas)View author publications

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Roger A’Hern MScView author publications

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J. Meirion Thomas MS, FRCS, FRCPView author publications

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Correspondence to Kasim A. Behranwala MS, DNB, FRCS (Ed), FRCS (Glas).

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Behranwala, K.A., A’Hern, R., Omar, AM. et al. Prognosis of Lymph Node Metastasis in Soft Tissue Sarcoma. Ann Surg Oncol 11, 714–719 (2004). https://doi.org/10.1245/ASO.2004.04.027

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Received: 28 April 2003

Accepted: 26 March 2004

Issue Date: July 2004

DOI: https://doi.org/10.1245/ASO.2004.04.027