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Value of the Sentinel Node Procedure in Pediatric Extremity Rhabdomyosarcoma: A Systematic Review and Retrospective
Bernadette Jeremiasse1, Alida F W van der Steeg1, Marta Fiocco2,3,4
1Pediatric Surgery, Pediatric Solid Tumor Unit, Princess Maxima Center for Pediatric Oncology, Utrecht, The Netherlands.
Insights
The sentinel node procedure (SNP) is a recommendable tool for staging pediatric extremity rhabdomyosarcoma (RMS). This method accurately changes nodal classification and offers targeted lymph node sampling for improved patient management.
Area of Science:
- Oncology
- Pediatric Surgery
Background:
- Lymph node metastases significantly impact prognosis in pediatric extremity rhabdomyosarcoma (RMS).
- Accurate nodal staging is crucial for effective treatment planning in pediatric RMS.
- Sentinel node procedure (SNP) offers a potential alternative to traditional lymph node sampling.
Purpose of the Study:
- To evaluate the recommendability of the sentinel node procedure (SNP) for pediatric patients diagnosed with extremity rhabdomyosarcoma (RMS).
Main Methods:
- A systematic review of published SNP cases was conducted.
- Data from 13 cases at the authors' institution and 8 unpublished cases from two other hospitals were included.
- Total patient cohort comprised 55 pediatric extremity RMS cases.
Main Results:
- At least one sentinel lymph node (SLN) was identified in all 55 patients, though SNP techniques varied.
- The SNP altered the nodal classification for 17.0% (8/55) of the patients.
- A false-negative rate of 10.5% was observed with the SNP.
Conclusions:
- The sentinel node procedure (SNP) is recommended for pediatric extremity RMS staging.
- SNP can effectively modify lymph node status assessment.
- SNP enables more targeted lymph node sampling compared to traditional methods, supporting its use alongside clinical and radiological assessment.
Background:
Our aim is to show whether the sentinel node procedure (SNP) is recommendable for pediatric patients with extremity rhabdomyosarcoma (RMS). Lymph node metastases are an important prognostic factor in pediatric patients with extremity RMS. Accurate nodal staging is necessary to treat the patient accordingly. An alternative to the current recommended lymph node sampling is the sentinel node procedure (SNP).
Methods:
A systematic review was performed summarizing all published cases of SNP in addition to 13 cases from our hospital and 8 cases from two other hospitals that have not been published before.
Results:
For all patients (n = 55), at least one SLN was identified, but the SNP technique used was not uniform. The SNP changed the nodal classification of eight patients (17.0%) and had a false-negative rate of 10.5%.
Conclusions:
The SNP is recommendable for pediatric patients with extremity RMS. It can change lymph node status and can be used to sample patients in a more targeted way than nodal sampling alone. Therefore, we recommend use of the SNP in addition to clinical and radiological nodal assessment for pediatric patients with extremity RMS.
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