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oai:recercat.cat:11351/137302025-10-24T10:41:24Zcom_2072_378070com_2072_378040col_2072_378092

Surgical Lymph Node Staging in Extremity Rhabdomyosarcoma: The EpSSG RMS 2005 Trial Experience Merks, Johannes Rogers, Timothy Craigie, Ross Terwisscha van Scheltinga, Sheila Guérin, Florent Guillén Burrieza, Gabriela Institut Català de la Salut [Terwisscha van Scheltinga S] Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands. [Merks JHM] Princess Máxima Center for Pediatric Oncology, Utrecht, The Netherlands. Division of Imaging and Oncology, University Medical Center Utrecht, University of Utrecht, Utrecht, The Netherlands. [Guerin F] Department of Pediatric Surgery, Assistance Publique Hôpitaux de Paris, University Paris-Saclay, Le Kremlin Bicêtre, France. [Rogers T] University Hospitals Bristol and Weston NHS Foundation Trust, Bristol, UK. [Craigie RJ] Department of Pediatric Surgery, Royal Manchester Children’s Hospital, Manchester, UK. [Guillén G] Unitat de Cirurgia Oncològica Pediàtrica, Servei de Cirurgia Pediàtrica, Vall d’Hebron Hospital Universitari, Barcelona, Spain Vall d'Hebron Barcelona Hospital Campus Nodes limfàtics - Biòpsia Tumors de parts toves - Tractament Nodes limfàtics - Cirurgia ANATOMY::Tissues::Lymphoid Tissue::Lymph Nodes DISEASES::Neoplasms::Neoplasms by Histologic Type::Neoplasms, Connective and Soft Tissue::Neoplasms, Muscle Tissue::Myosarcoma::Rhabdomyosarcoma Other subheadings::Other subheadings::/therapy ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Diagnostic Techniques and Procedures::Clinical Laboratory Techniques::Cytological Techniques::Cytodiagnosis::Biopsy ANALYTICAL, DIAGNOSTIC AND THERAPEUTIC TECHNIQUES, AND EQUIPMENT::Diagnosis::Prognosis::Neoplasm Staging ANATOMÍA::tejidos::tejido linfoide::ganglios linfáticos ENFERMEDADES::neoplasias::neoplasias por tipo histológico::neoplasias de tejido conjuntivo y de tejidos blandos::neoplasias de tejido muscular::miosarcoma::rabdomiosarcoma Otros calificadores::Otros calificadores::/terapia TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::técnicas y procedimientos diagnósticos::técnicas de laboratorio clínico::técnicas citológicas::citodiagnóstico::biopsia TÉCNICAS Y EQUIPOS ANALÍTICOS, DIAGNÓSTICOS Y TERAPÉUTICOS::diagnóstico::pronóstico::estadificación de neoplasias Biopsy; Extremity; Lymph nodes Biopsia; Extremidad; Ganglios linfáticos Biòpsia; Extremitat; Ganglis limfàtics Background The European pediatric soft tissue Sarcoma Study Group (EpSSG) RMS 2005 study recommends a lymph node biopsy for extremity rhabdomyosarcoma (RMS). The aim of our study was to analyze the results of the lymph node sampling strategies used, such as sentinel node biopsy (SNB) and nodal sampling (NS), and compare the outcome of patients undergoing different nodal staging techniques. Methods All non-metastatic (M0) patients registered in the EpSSG RMS 2005 study with an RMS of the extremity, presenting between 2005 and 2016, were included for analysis of the lymph node sampling techniques used. The secondary objective was to compare the results and outcome for the different sampling procedures. Results Of 198 patients, 144 had clinically/radiologically negative nodes (cN0), and 72/144 underwent a biopsy (26 SNB/46 NS). Final nodal status was upstaged to pN1 in 11/72 (15.3%) patients—6 after SNB and 5 after NS. In 54 radiologically malignant/suspicious-appearing nodes, 34 NS biopsies were performed, resulting in downstaging to N0 in 9/34 (26.5%) patients. 5-years overall survival (OS) of N0 patients versus N1 patients was 82.5% (95% confidence interval CI 74.7–88.0) versus 46.5% (95% CI 32.2–59.7). 5-years OS in N0 patients was not significantly different in biopsied and non-biopsied patients (p = 0.88). However, in N1 patients, survival was significantly better in biopsied compared with non-biopsied patients (p = 0.006). Conclusion Lymph node staging plays a crucial role in determining appropriate treatment strategies. Pathology of sampled lymph nodes can upstage or downstage the lymph node status, guiding treatment decisions based on the stage. 2025-09-29T07:57:43Z 2025-09-29T07:57:43Z 2025-10 info:eu-repo/semantics/article info:eu-repo/semantics/publishedVersion Terwisscha van Scheltinga S, Merks JHM, Guerin F, Rogers T, Craigie RJ, Guillén G, et al. Surgical Lymph Node Staging in Extremity Rhabdomyosarcoma: The EpSSG RMS 2005 Trial Experience. Ann Surg Oncol. 2025 Oct;32:7751–7761. 1534-4681 http://hdl.handle.net/11351/13730 10.1245/s10434-025-17908-3 40705262 001534698500001 http://hdl.handle.net/11351/13730 eng Annals of Surgical Oncology;32(10) https://doi.org/10.1245/s10434-025-17908-3 Attribution 4.0 International http://creativecommons.org/licenses/by/4.0/ info:eu-repo/semantics/openAccess application/pdf Springer Scientia