Cecilia E J Terwisscha van Scheltinga1, Pauline Spronk2, Joost van Rosmalen3, Marc H W A Wijnen4, Hugo A Heij5, Robertine van Baren6, Johannes H M Merks7, Max M van Noesel8, Rene M H Wijnen2. 1. Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands. Electronic address: c.terwisschavscheltinga@erasmusmc.nl. 2. Department of Pediatric Surgery, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands. 3. Departement of Biostatistics, Erasmus MC, Rotterdam, the Netherlands. 4. Department of Pediatric Surgery, UMCN, Nijmegen and AMC, Amsterdam, the Netherlands; Department of Pediatric Surgery, AMC, Amsterdam, the Netherlands. 5. Department of Pediatric Surgery, UMCN, Nijmegen and AMC, Amsterdam, the Netherlands. 6. Department of Pediatric Surgery, UMCG, Groningen, the Netherlands. 7. Department of Pediatric Oncology, EKZ/AMC, Amsterdam, the Netherlands. 8. Department of Pediatric Oncology/Hematology, Erasmus MC-Sophia Children's Hospital, Rotterdam, the Netherlands. Electronic address: m.vannoesel@erasmusmc.nl.
Abstract
BACKGROUND: In pediatric rhabdomyosarcoma (RMS), evaluation of lymph node involvement (N1) is an important staging aspect, but difficult to assess. The aim of our study was to evaluate the assessment of lymph node infiltration and impact on outcome in N1 RMS patients. METHODS: We identified 277 non-metastatic RMS patients diagnosed and treated between 1990 and 2008. Patients with recorded N1 disease were evaluated for their diagnostic procedures and outcome. RESULTS: In 13.7% N1 status was reported. In 19 of 34 N1 patients, lymph node biopsies were performed for histologically confirmation. Different treatment modalities were used to treat lymph node metastases. In total 23 of 31 patients received local treatment of the node (11/23 RT, 4/23 surgery, and 8/23 both). All patients received chemotherapy. Lymph node relapse occurred in 7 of 31 patients who were treated with one or two modalities. Only 1 (14%) of 8 patients treated with three modalities relapsed. In N0 patients 10 (4.2%) of 239 had a regional lymph node relapse, and 9 of 10 died. CONCLUSION: Lymph node metastases are an essential part of staging. Node positivity contributes to relapse of disease. Nodal relapse is also associated with a high mortality rate. These data imply that nodal assessment needs to be optimal and standardized for improved staging.
BACKGROUND: In pediatric rhabdomyosarcoma (RMS), evaluation of lymph node involvement (N1) is an important staging aspect, but difficult to assess. The aim of our study was to evaluate the assessment of lymph node infiltration and impact on outcome in N1 RMS patients. METHODS: We identified 277 non-metastatic RMS patients diagnosed and treated between 1990 and 2008. Patients with recorded N1 disease were evaluated for their diagnostic procedures and outcome. RESULTS: In 13.7% N1 status was reported. In 19 of 34 N1 patients, lymph node biopsies were performed for histologically confirmation. Different treatment modalities were used to treat lymph node metastases. In total 23 of 31 patients received local treatment of the node (11/23 RT, 4/23 surgery, and 8/23 both). All patients received chemotherapy. Lymph node relapse occurred in 7 of 31 patients who were treated with one or two modalities. Only 1 (14%) of 8 patients treated with three modalities relapsed. In N0 patients 10 (4.2%) of 239 had a regional lymph node relapse, and 9 of 10 died. CONCLUSION: Lymph node metastases are an essential part of staging. Node positivity contributes to relapse of disease. Nodal relapse is also associated with a high mortality rate. These data imply that nodal assessment needs to be optimal and standardized for improved staging.
Authors: Sheila E J Terwisscha van Scheltinga; Marc H W A Wijnen; Hélène Martelli; Timothy Rogers; Henry Mandeville; Mark N Gaze; Keiran McHugh; Nadege Corradini; Daniel Orbach; Meriel Jenney; Anna Kelsey; Julia Chisholm; Soledad Gallego; Heidi Glosli; Andrea Ferrari; Ilaria Zanetti; Gian Luca De Salvo; Veronique Minard-Colin; Giani Bisogno; Max M van Noesel; Hans H M Merks Journal: Cancer Med Date: 2020-09-01 Impact factor: 4.452
Authors: Roelof van Ewijk; Reineke A Schoot; Monika Sparber-Sauer; Simone A J Ter Horst; Nina Jehanno; Lise Borgwardt; Bart de Keizer; Johannes H M Merks; Alberto de Luca; Kieran McHugh; Thekla von Kalle; Jürgen F Schäfer; Rick R van Rijn Journal: Pediatr Radiol Date: 2021-06-17