Limits...
Local recurrence and assessment of sentinel lymph node biopsy in deep soft tissue leiomyosarcoma of the extremities.

Lamyman MJ, Giele HP, Critchley P, Whitwell D, Gibbons M, Athanasou NA - Clin Sarcoma Res (2011)

Bottom Line: Lymph node metastasis was seen in only two cases (7%); intratumoural lymphatics were identified in the primary tumours of both these cases.Local recurrence occurred in 25.9% of cases despite complete excision and post-operative radiotherapy; the mean time to recurrence was 10.1 months.On the basis of this study, we do not advocate sentinel lymph node biopsy in this group of patients except in those cases in which intratumoural lymphatics can be demonstrated.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: Leiomyosarcoma of deep soft tissues of the extremities is a rare malignant tumour treated primarily by surgery. The incidence of local recurrence and lymph node metastasis is uncertain and it is not known whether a sentinel lymph node biopsy is indicated in these tumours.

Methods: A retrospective review of patients treated for extremity deep soft tissue leiomyosarcoma at our institution over a 10-year period was conducted. Patients developing local recurrence or lymph node metastasis were identified. The presence or absence of lymphatics in the primary tumours was assessed by immunohistochemical expression of LYVE-1 and podoplanin.

Results: 27 patients (mean age 62 years) were included in the study. 15 were female and 12 male. Lymph node metastasis was seen in only two cases (7%); intratumoural lymphatics were identified in the primary tumours of both these cases. Local recurrence occurred in 25.9% of cases despite complete excision and post-operative radiotherapy; the mean time to recurrence was 10.1 months.

Conclusion: On the basis of this study, we do not advocate sentinel lymph node biopsy in this group of patients except in those cases in which intratumoural lymphatics can be demonstrated. Close follow up is important especially for high grade leiomyosarcomas, particularly in the first year, as these tumours have a high incidence of local recurrence.

No MeSH data available.


Related in: MedlinePlus

Age and sex distribution of cases.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
getmorefigures.php?uid=PMC3351718&req=5

Figure 1: Age and sex distribution of cases.

Mentions: 35 patients were identified as eligible for entry into the study. Five patients had to be excluded as either the case notes could not be found or were incomplete. Two patients were excluded because they died following their biopsy but before definitive surgery, and one patient was excluded because metastatic disease was found on presentation. The case notes of the remaining 27 patients were reviewed. Fifteen were female and twelve male (Figure 1). The mean age at presentation was 62 years. The mean follow up was 19.9 months, median 15 months (range 4 to 59 months). The sites of the primary tumour are shown in Figure 2. The size, grade and stage of the tumours are shown in Table 1. In all cases, local excision of the tumours was performed aiming for complete clearance with as wide a margin as possible. 21 of the patients (78%) received adjuvant radiotherapy following primary excision. Details of patients developing local recurrence are shown in Table 2 and of those developing lymph node metastasis in Table 3. Lymph node metastasis occurred in two patients (7%).


Local recurrence and assessment of sentinel lymph node biopsy in deep soft tissue leiomyosarcoma of the extremities.

Lamyman MJ, Giele HP, Critchley P, Whitwell D, Gibbons M, Athanasou NA - Clin Sarcoma Res (2011)

Age and sex distribution of cases.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC3351718&req=5

Figure 1: Age and sex distribution of cases.
Mentions: 35 patients were identified as eligible for entry into the study. Five patients had to be excluded as either the case notes could not be found or were incomplete. Two patients were excluded because they died following their biopsy but before definitive surgery, and one patient was excluded because metastatic disease was found on presentation. The case notes of the remaining 27 patients were reviewed. Fifteen were female and twelve male (Figure 1). The mean age at presentation was 62 years. The mean follow up was 19.9 months, median 15 months (range 4 to 59 months). The sites of the primary tumour are shown in Figure 2. The size, grade and stage of the tumours are shown in Table 1. In all cases, local excision of the tumours was performed aiming for complete clearance with as wide a margin as possible. 21 of the patients (78%) received adjuvant radiotherapy following primary excision. Details of patients developing local recurrence are shown in Table 2 and of those developing lymph node metastasis in Table 3. Lymph node metastasis occurred in two patients (7%).

Bottom Line: Lymph node metastasis was seen in only two cases (7%); intratumoural lymphatics were identified in the primary tumours of both these cases.Local recurrence occurred in 25.9% of cases despite complete excision and post-operative radiotherapy; the mean time to recurrence was 10.1 months.On the basis of this study, we do not advocate sentinel lymph node biopsy in this group of patients except in those cases in which intratumoural lymphatics can be demonstrated.

View Article: PubMed Central - HTML - PubMed

ABSTRACT

Background: Leiomyosarcoma of deep soft tissues of the extremities is a rare malignant tumour treated primarily by surgery. The incidence of local recurrence and lymph node metastasis is uncertain and it is not known whether a sentinel lymph node biopsy is indicated in these tumours.

Methods: A retrospective review of patients treated for extremity deep soft tissue leiomyosarcoma at our institution over a 10-year period was conducted. Patients developing local recurrence or lymph node metastasis were identified. The presence or absence of lymphatics in the primary tumours was assessed by immunohistochemical expression of LYVE-1 and podoplanin.

Results: 27 patients (mean age 62 years) were included in the study. 15 were female and 12 male. Lymph node metastasis was seen in only two cases (7%); intratumoural lymphatics were identified in the primary tumours of both these cases. Local recurrence occurred in 25.9% of cases despite complete excision and post-operative radiotherapy; the mean time to recurrence was 10.1 months.

Conclusion: On the basis of this study, we do not advocate sentinel lymph node biopsy in this group of patients except in those cases in which intratumoural lymphatics can be demonstrated. Close follow up is important especially for high grade leiomyosarcomas, particularly in the first year, as these tumours have a high incidence of local recurrence.

No MeSH data available.


Related in: MedlinePlus