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Review
. 2024 Jan 5;31(1):307-323.
doi: 10.3390/curroncol31010020.

Review on Lymph Node Metastases, Sentinel Lymph Node Biopsy, and Lymphadenectomy in Sarcoma

Paulina Chmiel  1 , Maria Krotewicz  1 , Anna Szumera-Ciećkiewicz  2 , Ewa Bartnik  3   4 , Anna M Czarnecka  1 , Piotr Rutkowski  1
Affiliations
Review

Review on Lymph Node Metastases, Sentinel Lymph Node Biopsy, and Lymphadenectomy in Sarcoma

Paulina Chmiel et al. Curr Oncol. .

Abstract

Soft tissue sarcomas (STS) originating from connective tissue rarely affect the lymph nodes. However, involvement of lymph nodes in STS is an important aspect of prognosis and treatment. Currently, there is no consensus on the diagnosis and management of lymph node metastases in STS. The key risk factor for nodal involvement is the histological subtype of sarcoma. Radiological and pathological evaluation seems to be the most effective method of assessing lymph nodes in these neoplasms. Thus, sentinel lymph node biopsy (SLNB), which has been shown to be valuable in the management of melanoma or breast cancer, may also be a beneficial diagnostic option in some high-risk STS subtypes. This review summarizes data on the risk factors and clinical characteristics of lymph node involvement in STS. Possible management and therapeutic options are also discussed.

Keywords: STS; lymph nodes; lymphadenectomy; metastasis; prognosis; sarcoma; soft tissue sarcoma; treatment.

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Conflict of interest statement

The authors declare no conflict of interest.

Figures

Figure 1
Figure 1
Clear cell sarcoma lymph multifocal metastasis (HE); the cytological image of the metastasis (A) and the morphology of the primary lesion (B) with the a majority of small round cells and scattered large pleomorphic cells. In the lymph node with multifocal, extensive metastases (C—dotted line), both morphological types of cells are seen (C1—small round cells and C2—pleomorphic, highly atypical).
Figure 2
Figure 2
Lymph metastasis of epithelioid sarcoma and extension of the lymph node capsule (the dotted line) and invasion of fat tissue (asterix). Epithelial sarcoma typically expresses CA125, ERG, and cytokeratin (CKAE1/EA3). INI1 nuclear loss of INI1 expression is a characteristic feature (arrows—positive internal control in the endothelium).
Figure 3
Figure 3
(A) Photograph of the beginning of axillary lymphadenectomy surgery. Patient with the diagnosis of rhabdomyosarcoma. (B) After administration of the patented blau dye. (C) After administration of the patented blau dye.
See this image and copyright information in PMC

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