Value of the Sentinel Node Procedure in Pediatric Extremity Rhabdomyosarcoma: A Systematic Review and Retrospective Cohort Study

Ann Surg Oncol. 2021 Dec;28(13):9048-9059. doi: 10.1245/s10434-021-10035-9. Epub 2021 May 31.

Abstract

Background: Our aim is to show whether the sentinel node procedure (SNP) is recommendable for pediatric patients with extremity rhabdomyosarcoma (RMS). Lymph node metastases are an important prognostic factor in pediatric patients with extremity RMS. Accurate nodal staging is necessary to treat the patient accordingly. An alternative to the current recommended lymph node sampling is the sentinel node procedure (SNP).

Methods: A systematic review was performed summarizing all published cases of SNP in addition to 13 cases from our hospital and 8 cases from two other hospitals that have not been published before.

Results: For all patients (n = 55), at least one SLN was identified, but the SNP technique used was not uniform. The SNP changed the nodal classification of eight patients (17.0%) and had a false-negative rate of 10.5%.

Conclusions: The SNP is recommendable for pediatric patients with extremity RMS. It can change lymph node status and can be used to sample patients in a more targeted way than nodal sampling alone. Therefore, we recommend use of the SNP in addition to clinical and radiological nodal assessment for pediatric patients with extremity RMS.

Publication types

  • Systematic Review

MeSH terms

  • Child
  • Extremities / pathology
  • Extremities / surgery
  • Humans
  • Lymph Node Excision
  • Lymph Nodes / pathology
  • Lymph Nodes / surgery
  • Neoplasm Staging
  • Retrospective Studies
  • Rhabdomyosarcoma* / pathology
  • Rhabdomyosarcoma* / surgery
  • Sentinel Lymph Node Biopsy
  • Sentinel Lymph Node* / pathology
  • Sentinel Lymph Node* / surgery