Examination of national lymph node evaluation practices for adult extremity soft tissue sarcoma
Background and Objectives Lymph node evaluation recommendations for extremity soft tissue sarcoma (ESTS) are absent from national guidelines. Our objectives were (1) to assess rates and predictors of nodal evaluation, and (2) to assess rates and predictors of nodal metastases. Methods ESTS patients...
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| Published in | Journal of surgical oncology Vol. 110; no. 6; pp. 682 - 688 |
|---|---|
| Main Authors | , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
United States
Blackwell Publishing Ltd
01.11.2014
Wiley Subscription Services, Inc |
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| Abstract | Background and Objectives
Lymph node evaluation recommendations for extremity soft tissue sarcoma (ESTS) are absent from national guidelines. Our objectives were (1) to assess rates and predictors of nodal evaluation, and (2) to assess rates and predictors of nodal metastases.
Methods
ESTS patients from the National Cancer Data Base (2000–2009) were assessed, and regression models were used to identify factors associated with nodal evaluation and metastases.
Results
Of 27,536 ESTS patients, 1,924 (7%) underwent nodal evaluation, and of these, 290 (15%) had nodal metastases. Nodal evaluation was most frequently performed for rhabdomyosarcoma (15.6%), angiosarcoma (10.0%), clear cell sarcoma (39.3%), epithelioid sarcoma (28.1%), and synovial sarcoma (9.3%). On multivariable analysis, factors associated with nodal evaluation included histologic subtype, tumor size, and grade. Nodal metastasis rates were highest among patients with rhabdomyosarcoma (32.1%), angiosarcoma (24.1%), clear cell sarcoma (27.7%), and epithelioid sarcoma (31.8%). On multivariable analysis, factors associated with nodal metastases included histologic subtype, tumor size, and grade.
Conclusions
Nodal evaluation rates are highest among certain expected subtypes but are generally low. However, nodal metastasis rates for many histologic subtypes in patients selected for lymph node evaluation may be higher than previously reported. Multi‐institutional studies should address nodal evaluation for ESTS. J. Surg. Oncol. 2014 110:682–688. © 2014 Wiley Periodicals, Inc. |
|---|---|
| AbstractList | Background and Objectives
Lymph node evaluation recommendations for extremity soft tissue sarcoma (ESTS) are absent from national guidelines. Our objectives were (1) to assess rates and predictors of nodal evaluation, and (2) to assess rates and predictors of nodal metastases.
Methods
ESTS patients from the National Cancer Data Base (2000–2009) were assessed, and regression models were used to identify factors associated with nodal evaluation and metastases.
Results
Of 27,536 ESTS patients, 1,924 (7%) underwent nodal evaluation, and of these, 290 (15%) had nodal metastases. Nodal evaluation was most frequently performed for rhabdomyosarcoma (15.6%), angiosarcoma (10.0%), clear cell sarcoma (39.3%), epithelioid sarcoma (28.1%), and synovial sarcoma (9.3%). On multivariable analysis, factors associated with nodal evaluation included histologic subtype, tumor size, and grade. Nodal metastasis rates were highest among patients with rhabdomyosarcoma (32.1%), angiosarcoma (24.1%), clear cell sarcoma (27.7%), and epithelioid sarcoma (31.8%). On multivariable analysis, factors associated with nodal metastases included histologic subtype, tumor size, and grade.
Conclusions
Nodal evaluation rates are highest among certain expected subtypes but are generally low. However, nodal metastasis rates for many histologic subtypes in patients selected for lymph node evaluation may be higher than previously reported. Multi‐institutional studies should address nodal evaluation for ESTS. J. Surg. Oncol. 2014 110:682–688. © 2014 Wiley Periodicals, Inc. BACKGROUND AND OBJECTIVESLymph node evaluation recommendations for extremity soft tissue sarcoma (ESTS) are absent from national guidelines. Our objectives were (1) to assess rates and predictors of nodal evaluation, and (2) to assess rates and predictors of nodal metastases.METHODSESTS patients from the National Cancer Data Base (2000-2009) were assessed, and regression models were used to identify factors associated with nodal evaluation and metastases.RESULTSOf 27,536 ESTS patients, 1,924 (7%) underwent nodal evaluation, and of these, 290 (15%) had nodal metastases. Nodal evaluation was most frequently performed for rhabdomyosarcoma (15.6%), angiosarcoma (10.0%), clear cell sarcoma (39.3%), epithelioid sarcoma (28.1%), and synovial sarcoma (9.3%). On multivariable analysis, factors associated with nodal evaluation included histologic subtype, tumor size, and grade. Nodal metastasis rates were highest among patients with rhabdomyosarcoma (32.1%), angiosarcoma (24.1%), clear cell sarcoma (27.7%), and epithelioid sarcoma (31.8%). On multivariable analysis, factors associated with nodal metastases included histologic subtype, tumor size, and grade.CONCLUSIONSNodal evaluation rates are highest among certain expected subtypes but are generally low. However, nodal metastasis rates for many histologic subtypes in patients selected for lymph node evaluation may be higher than previously reported. Multi-institutional studies should address nodal evaluation for ESTS. Background and Objectives Lymph node evaluation recommendations for extremity soft tissue sarcoma (ESTS) are absent from national guidelines. Our objectives were (1) to assess rates and predictors of nodal evaluation, and (2) to assess rates and predictors of nodal metastases. Methods ESTS patients from the National Cancer Data Base (2000–2009) were assessed, and regression models were used to identify factors associated with nodal evaluation and metastases. Results Of 27,536 ESTS patients, 1,924 (7%) underwent nodal evaluation, and of these, 290 (15%) had nodal metastases. Nodal evaluation was most frequently performed for rhabdomyosarcoma (15.6%), angiosarcoma (10.0%), clear cell sarcoma (39.3%), epithelioid sarcoma (28.1%), and synovial sarcoma (9.3%). On multivariable analysis, factors associated with nodal evaluation included histologic subtype, tumor size, and grade. Nodal metastasis rates were highest among patients with rhabdomyosarcoma (32.1%), angiosarcoma (24.1%), clear cell sarcoma (27.7%), and epithelioid sarcoma (31.8%). On multivariable analysis, factors associated with nodal metastases included histologic subtype, tumor size, and grade. Conclusions Nodal evaluation rates are highest among certain expected subtypes but are generally low. However, nodal metastasis rates for many histologic subtypes in patients selected for lymph node evaluation may be higher than previously reported. Multi‐institutional studies should address nodal evaluation for ESTS. J. Surg. Oncol. 2014 110:682–688 . © 2014 Wiley Periodicals, Inc. Lymph node evaluation recommendations for extremity soft tissue sarcoma (ESTS) are absent from national guidelines. Our objectives were (1) to assess rates and predictors of nodal evaluation, and (2) to assess rates and predictors of nodal metastases. ESTS patients from the National Cancer Data Base (2000-2009) were assessed, and regression models were used to identify factors associated with nodal evaluation and metastases. Of 27,536 ESTS patients, 1,924 (7%) underwent nodal evaluation, and of these, 290 (15%) had nodal metastases. Nodal evaluation was most frequently performed for rhabdomyosarcoma (15.6%), angiosarcoma (10.0%), clear cell sarcoma (39.3%), epithelioid sarcoma (28.1%), and synovial sarcoma (9.3%). On multivariable analysis, factors associated with nodal evaluation included histologic subtype, tumor size, and grade. Nodal metastasis rates were highest among patients with rhabdomyosarcoma (32.1%), angiosarcoma (24.1%), clear cell sarcoma (27.7%), and epithelioid sarcoma (31.8%). On multivariable analysis, factors associated with nodal metastases included histologic subtype, tumor size, and grade. Nodal evaluation rates are highest among certain expected subtypes but are generally low. However, nodal metastasis rates for many histologic subtypes in patients selected for lymph node evaluation may be higher than previously reported. Multi-institutional studies should address nodal evaluation for ESTS. Background and Objectives Lymph node evaluation recommendations for extremity soft tissue sarcoma (ESTS) are absent from national guidelines. Our objectives were (1) to assess rates and predictors of nodal evaluation, and (2) to assess rates and predictors of nodal metastases. Methods ESTS patients from the National Cancer Data Base (2000-2009) were assessed, and regression models were used to identify factors associated with nodal evaluation and metastases. Results Of 27,536 ESTS patients, 1,924 (7%) underwent nodal evaluation, and of these, 290 (15%) had nodal metastases. Nodal evaluation was most frequently performed for rhabdomyosarcoma (15.6%), angiosarcoma (10.0%), clear cell sarcoma (39.3%), epithelioid sarcoma (28.1%), and synovial sarcoma (9.3%). On multivariable analysis, factors associated with nodal evaluation included histologic subtype, tumor size, and grade. Nodal metastasis rates were highest among patients with rhabdomyosarcoma (32.1%), angiosarcoma (24.1%), clear cell sarcoma (27.7%), and epithelioid sarcoma (31.8%). On multivariable analysis, factors associated with nodal metastases included histologic subtype, tumor size, and grade. Conclusions Nodal evaluation rates are highest among certain expected subtypes but are generally low. However, nodal metastasis rates for many histologic subtypes in patients selected for lymph node evaluation may be higher than previously reported. Multi-institutional studies should address nodal evaluation for ESTS. J. Surg. Oncol. 2014 110:682-688. © 2014 Wiley Periodicals, Inc. |
| Author | Hayes, John P. Kinnier, Christine V. Attar, Samer Wayne, Jeffrey D. Laskin, William B. Farina, Domenico A. Peabody, Terrance Bilimoria, Karl Y. Sherman, Karen L. Agulnik, Mark |
| Author_xml | – sequence: 1 givenname: Karen L. surname: Sherman fullname: Sherman, Karen L. organization: Northwestern Institute for Comparative Effectiveness Research (NICER) in Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois – sequence: 2 givenname: Christine V. surname: Kinnier fullname: Kinnier, Christine V. organization: Northwestern Institute for Comparative Effectiveness Research (NICER) in Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois – sequence: 3 givenname: Domenico A. surname: Farina fullname: Farina, Domenico A. organization: Northwestern Institute for Comparative Effectiveness Research (NICER) in Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois – sequence: 4 givenname: Jeffrey D. surname: Wayne fullname: Wayne, Jeffrey D. organization: Northwestern Institute for Comparative Effectiveness Research (NICER) in Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois – sequence: 5 givenname: William B. surname: Laskin fullname: Laskin, William B. organization: Northwestern Institute for Comparative Effectiveness Research (NICER) in Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois – sequence: 6 givenname: Mark surname: Agulnik fullname: Agulnik, Mark organization: Northwestern Institute for Comparative Effectiveness Research (NICER) in Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois – sequence: 7 givenname: Samer surname: Attar fullname: Attar, Samer organization: Northwestern Institute for Comparative Effectiveness Research (NICER) in Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois – sequence: 8 givenname: John P. surname: Hayes fullname: Hayes, John P. organization: Northwestern Institute for Comparative Effectiveness Research (NICER) in Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois – sequence: 9 givenname: Terrance surname: Peabody fullname: Peabody, Terrance organization: Northwestern Institute for Comparative Effectiveness Research (NICER) in Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois – sequence: 10 givenname: Karl Y. surname: Bilimoria fullname: Bilimoria, Karl Y. email: k-bilimoria@northwestern.edu organization: Northwestern Institute for Comparative Effectiveness Research (NICER) in Oncology, Robert H. Lurie Comprehensive Cancer Center, Chicago, Illinois |
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| Snippet | Background and Objectives
Lymph node evaluation recommendations for extremity soft tissue sarcoma (ESTS) are absent from national guidelines. Our objectives... Lymph node evaluation recommendations for extremity soft tissue sarcoma (ESTS) are absent from national guidelines. Our objectives were (1) to assess rates and... Background and Objectives Lymph node evaluation recommendations for extremity soft tissue sarcoma (ESTS) are absent from national guidelines. Our objectives... BACKGROUND AND OBJECTIVESLymph node evaluation recommendations for extremity soft tissue sarcoma (ESTS) are absent from national guidelines. Our objectives... |
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| SubjectTerms | Adult Aged Databases, Factual Extremities Female Humans lymph node excision Lymph Nodes - pathology Lymphatic Metastasis Male Middle Aged Multivariate Analysis Neoplasm Grading neoplasms Practice Patterns, Physicians' - statistics & numerical data retrospective studies Sarcoma - secondary Soft Tissue Neoplasms - pathology United States |
| Title | Examination of national lymph node evaluation practices for adult extremity soft tissue sarcoma |
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