Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2025 Feb;30(2):407-416.
doi: 10.1007/s10147-024-02674-1. Epub 2024 Dec 19.

Prognostic significance of lymph node metastasis of soft tissue sarcoma of the extremities. National cancer institute experience

Mohamed Shalaby  1 , Rasha M Allam  2 , Mohamed A Elkordy  3 , Mohammad Taher  3   4
Affiliations

Prognostic significance of lymph node metastasis of soft tissue sarcoma of the extremities. National cancer institute experience

Mohamed Shalaby et al. Int J Clin Oncol. 2025 Feb.

Abstract

Background and objective: Lymph node metastasis (LNM) in soft tissue sarcoma (STS) of the extremities is relatively rare. We aimed to evaluate the prognosis and the survival of patients with LNM and correlate them to the pattern of metastasis.

Methods: A retrospective study of patients diagnosed with STS of the extremities from 2015 to 2019.

Results: 111/1506 patients (7.4%) had LNM. Nodal metastasis was correlated significantly with old age, advanced tumor stages, high-grade tumors, presence of Lymphovascular invasion (LVI), and resection margins < = 2 cm. Metachronous LNM was documented in 96 patients (86.5%) and synchronous LNM in 15 patients (13.5%). The 6-year overall survival (OS) was 36.3% for those with LNM and 52.9% for those without LNM. The 6-year disease-free survival (DFS) was 5.7% for those with LNM and 32.6% for those without LNM. Metachronus pattern of LNM showed a significantly poorer outcome regarding 6-year OS and DFS than the synchronous pattern.

Conclusions: LNM significantly negatively predicts OS and DFS in the extremities' STS. In particular, the metachronous pattern of LNM indicates a grave prognosis as these patients are supposed to harbor an occult LNM at presentation and were not subjected to lymphadenectomy at their initial primary treatment surgery. Therefore, seeking a valid noninvasive diagnostic tool such as sentinel lymph node biopsy to detect nodal metastasis is necessary.

Keywords: Lymph node metastasis; Metachronous nodal metastasis; Sentinel lymph node biopsy; Soft tissue sarcoma of extremities; Synchronous nodal metastasis.

PubMed Disclaimer

Conflict of interest statement

Declarations. Conflict of interest: All the authors declare no financial interest or any other potential conflict of interest.

Similar articles

See all similar articles

References

    1. Basile G, Mattei JC, Alshaygy I et al (2020) Curability of patients with lymph node metastases from extremity soft-tissue sarcoma. Cancer 126:5098–5108. https://doi.org/10.1002/cncr.33189 - DOI - PubMed
    1. Zagars GK, Ballo MT, Pisters PWT et al (2003) Prognostic factors for patients with localized soft-tissue sarcoma treated with conservation surgery and radiation therapy. Cancer 97:2530–2543. https://doi.org/10.1002/CNCR.11365 - DOI - PubMed
    1. Daigeler A, Kuhnen C, Moritz R et al (2009) Lymph node metastases in soft tissue sarcomas-a single center analysis of 1597 patients. Langenbeck Arch Surg 394:321–329. https://doi.org/10.1007/S00423-008-0371-X/FIGURES/5 - DOI
    1. Yanagawa T, Saito K, Takagishi K (2014) Risk factors for lymphatic metastasis of malignant bone and soft-tissue tumors: a retrospective cohort study of 242 patients. Med (United States). https://doi.org/10.1097/MD.0000000000000225 - DOI
    1. Keung EZ, Chiang YJ, Voss RK et al (2018) Defining the incidence and clinical significance of lymph node metastasis in soft tissue sarcoma. Eur J Surg Oncol 44:170–177. https://doi.org/10.1016/J.EJSO.2017.11.014 - DOI - PubMed

LinkOut - more resources