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Role of sentinel lymph node biopsy in the staging of synovial, epithelioid, and clear cell sarcomas
Annals of Surgical Oncology, 03/10/09

Maduekwe UN et al. - In a trial to determine the utility of sentinel lymph node biopsy (SLNB) for pts with synovial, epithelioid, and clear cell sarcoma subtypes, it was found that for pts with these sarcoma subtypes without radiological evidence of nodal or distant metastases, incidence of occult lymph node metastasis is relatively low.

Methods

29 pts with nonmetastatic synovial, epithelioid, and clear cell sarcomas who underwent SLNB were examined.

Results

Median age was 35 yrs, and 69% were male.
Tumors were located in the lower extremity in 17 pts and the upper extremity in 12; histological subtypes were synovial sarcoma in 16 pts, epithelioid sarcoma in 10, and clear cell sarcoma in 3.
All pts had a staging chest computed tomography (CT) scan, none of which were suspicious, and 20 pts had staging positron emission tomography (PET) scans (16 negative, 3 indeterminate, and 1 suspicious).
All pts had resection of their primary tumor.
At least 1 sentinel node was found in 28 pts (97%), and median number of sentinel nodes identified was 2.
1 pt had a positive sentinel node on routine hematoxylin and eosin (H&E) staining and developed lung metastases.
2 pts had positive sentinel nodes following immunohistochemical staining, and both remain disease free despite not undergoing completion lymphadenectomy.
1 pt developed a lymph node metastasis after a negative SLNB.

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