Sentinel Lymph Node Biopsy in pediatric soft tissue sarcoma patients: Utility and concordance with imaging

• Published in: Journal of pediatric surgery 2013-09, Vol.48 (9), p.1903-1906
• Main Authors: Alcorn, Kaitlyn M, Deans, Katherine J, Congeni, Anthony, Sulkowski, Jason P, Bagatell, Rochelle, Mattei, Peter, Minneci, Peter C
• Format: Article
• Language: English
• Subjects: Adolescent; Child; Child, Preschool; Coloring Agents; CT scan; 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; Pediatrics; PET; Positron emission tomography; Predictive Value of Tests; Preoperative Care; Reproducibility of Results; Retrospective Studies; Rhabdomyosarcoma - diagnostic imaging; Rhabdomyosarcoma - secondary; Rhabdomyosarcoma - surgery; Rosaniline Dyes; Sarcoma; Sarcoma - diagnostic imaging; Sarcoma - secondary; Sarcoma - surgery; Sensitivity and Specificity; Sentinel lymph node; Sentinel Lymph Node Biopsy - methods; Soft Tissue Neoplasms - diagnostic imaging; Soft Tissue Neoplasms - pathology; Soft Tissue Neoplasms - surgery; Surgery; Tomography, X-Ray Computed
• ISSN: 0022-3468; 1531-5037
• 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 and18 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.