Experience with 31 sentinel lymph node biopsies for sarcomas and carcinomas in pediatric patients Journal Article


Authors: Kayton, M. L.; Delgado, R.; Busam, K.; Cody, H. S. 3rd; Athanasian, E. A.; Coit, D.; La Quaglia, M. P.
Article Title: Experience with 31 sentinel lymph node biopsies for sarcomas and carcinomas in pediatric patients
Abstract: BACKGROUND. Few data exist regarding techniques, indications, and outcomes for sentinel lymph node biopsy in pediatric patients with sarcomas and carcinomas. METHODS. A retrospective 10-year review was conducted, with Institutional Review Board waiver, of the pathology, lymphoscintigraphy, and clinical records for all pediatric patients selected to undergo sentinel lymph node biopsy at a major cancer center. RESULTS. Thirty-one sentinel lymph node biopsies were performed in 30 pediatric patients (median age, 12 years; range, 2-21 years). With the administration of technetium 99m sulfur colloid, sentinel lymph nodes were identified preoperatively in 30 of 31 cases, and intraoperatively in the remaining case. Radiotracer alone was used in 13 of 31 cases but was supplemented with isosulfan blue dye in the remaining 18 cases. There were no complications. Positive sentinel lymph nodes occurred in 1 of 9 patients with rhabdomyosarcoma and in 2 of 5 patients with breast cancer, and in both of these diseases the sentinel lymph node results helped guide treatment decisions. No other patients had positive sentinel lymph nodes, and among those with nonrhabdomyosarcoma soft-tissue sarcomas there were no lymph node basin recurrences despite a lack of lymph node basin irradiation or formal lymph node dissection. The median follow-up was 48 months (range, 0-111 months). CONCLUSIONS. Sentinel lymph node biopsy for pediatric soft-tissue tumors can be performed safely, and the results can alter treatment decisions both for children with rhabdomyosarcoma and adolescents with breast cancer. In patients with nonrhabdomyosarcoma soft-tissue sarcoma, we observed no positive sentinel lymph nodes and no lymph node basin recurrences; these data should prompt the prospective study of sentinel lymph node biopsy as a modality that might help guide the administration or withholding of regional therapy among pediatric patients with nonrhabdomyosarcoma soft-tissue sarcoma. © 2008 American Cancer Society.
Keywords: adolescent; adult; child; clinical article; human tissue; preschool child; school child; child, preschool; middle aged; retrospective studies; cancer recurrence; cancer patient; follow up; lymph node dissection; lymphoscintigraphy; sentinel lymph node; sentinel lymph node biopsy; medical decision making; breast cancer; pathology; breast neoplasms; retrospective study; childhood cancer; pediatric; sarcoma; cancer center; preoperative period; intraoperative period; breast tumor; breast carcinoma; patient safety; carcinoma; soft tissue sarcoma; rhabdomyosarcoma; synovial sarcoma; epithelioid sarcoma; clear cell sarcoma; sarcoma, clear cell; alveolar soft part sarcoma; technetium sulfur colloid tc 99m; lymphography; nonrhabdomyosarcoma; sarcoma, alveolar soft part
Journal Title: Cancer
Volume: 112
Issue: 9
ISSN: 0008-543X
Publisher: Wiley Blackwell  
Date Published: 2008-05-01
Start Page: 2052
End Page: 2059
Language: English
DOI: 10.1002/cncr.23403
PUBMED: 18338809
PROVIDER: scopus
DOI/URL:
Notes: --- - "Cited By (since 1996): 12" - "Export Date: 17 November 2011" - "CODEN: CANCA" - "Source: Scopus"
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  1. Hiram S Cody III
    242 Cody
  2. Ruby Delgado
    26 Delgado
  3. Mark Lawrence Kayton
    19 Kayton
  4. Daniel Coit
    542 Coit
  5. Klaus J Busam
    688 Busam