Clinically node negative sarcoma patients may still need pathologic nodal evaluation

Pathologic nodal evaluation should be considered in clinically node-negative patients with certain synovial, clear cell, angiosarcoma, rhabdomyosarcoma, and epithelioid (SCARE) soft tissue sarcoma, according to a study.

Of the 4158 patients included in this study with SCARE soft tissue sarcomas without clinical nodal involvement undergoing surgical resection, 669 patients (16%) underwent regional lymph node surgery (RLNS), with patients with epithelioid and clear cell sarcomas the most likely to undergo RLNS. Overall, 45 patients (7%) had positive nodes, with patients with clear cell sarcoma and angiosarcoma having the highest rate of nodal positivity at 14% and 13%, respectively.

There was a reduced 5-year overall survival in patients with positive nodes and the stratification was largest in clear cell and angiosarcoma.

Reference

Maduekwe UN, Herb JN, Esther RJ, et al. Pathologic nodal staging for clinically node-negative soft tissue sarcoma of the extremities. J Surg Oncol. 2021; DOI: 10.1002/jso.26465. Epub ahead of print. PMID: 33751586.