Sentinel lymph node biopsy in pediatric soft tissue sarcoma patients: utility and concordance with imaging

J Pediatr Surg. 2013 Sep;48(9):1903-6. doi: 10.1016/j.jpedsurg.2013.04.013.

Abstract

Background: The purpose of this study was to report our experience with sentinel lymph node biopsy (SLNB) for pediatric soft tissue sarcomas to add to the limited literature about its feasibility, utility, and concordance with pre-operative imaging, including CT and (18)F-FDG PET (PET) scanning.

Methods: Medical records of patients with a sarcoma who underwent SLNB as part of their treatment for a soft tissue sarcoma at our institution from 2000 to 2011 were identified and reviewed.

Results: Eight patients underwent SLNB for soft tissue sarcoma during the study period. Two patients had positive SLNBs; both of these patients had rhabdomyosarcoma. Three patients with pathologically enlarged lymph nodes on CT scan underwent PET functional imaging prior to SLNB. The PET suggested the presence of nodal disease in all three patients; however, only one of these patients had a positive SLNB.

Conclusions: Our series confirms that SLNB is feasible in pediatric sarcoma patients. Small numbers preclude definitive conclusions regarding the utility of SLNB compared with PET, however our data suggest functional imaging alone may not be sufficient to definitively determine lymph node status in these patients. Surgical lymph node sampling may still need to be performed to accurately identify nodal status in pediatric patients with soft tissue sarcoma.

Keywords: CT scan; PET; Pediatrics; Positron emission tomography; Sarcoma; Sentinel lymph node.

Publication types

  • Comparative Study
  • Research Support, Non-U.S. Gov't
  • Validation Study

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Coloring Agents
  • Feasibility Studies
  • Female
  • Humans
  • Infant
  • Lymph Nodes / diagnostic imaging
  • Lymph Nodes / pathology
  • Lymphatic Metastasis / diagnosis*
  • Lymphatic Metastasis / diagnostic imaging
  • Lymphoscintigraphy*
  • Male
  • Multimodal Imaging*
  • Neoplasm Staging / methods*
  • Positron-Emission Tomography
  • Predictive Value of Tests
  • Preoperative Care
  • Reproducibility of Results
  • Retrospective Studies
  • Rhabdomyosarcoma / diagnostic imaging
  • Rhabdomyosarcoma / secondary
  • Rhabdomyosarcoma / surgery
  • Rosaniline Dyes
  • Sarcoma / diagnostic imaging
  • Sarcoma / secondary*
  • Sarcoma / surgery
  • Sensitivity and Specificity
  • Sentinel Lymph Node Biopsy* / methods
  • Soft Tissue Neoplasms / diagnostic imaging
  • Soft Tissue Neoplasms / pathology*
  • Soft Tissue Neoplasms / surgery
  • Tomography, X-Ray Computed

Substances

  • Coloring Agents
  • Rosaniline Dyes
  • iso-sulfan blue