Sarah S. Donaldson, M.D.

Publication Details

  • REGIONAL NODAL INVOLVEMENT AND PATTERNS OF SPREAD ALONG IN-TRANSIT PATHWAYS IN CHILDREN WITH RHABDOMYOSARCOMA OF THE EXTREMITY: A REPORT FROM THE CHILDREN'S ONCOLOGY GROUP INTERNATIONAL JOURNAL OF RADIATION ONCOLOGY BIOLOGY PHYSICS La, T. H., Wolden, S. L., Rodeberg, D. A., Hawkins, D. S., Brown, K. L., Anderson, J. R., Donaldson, S. S. 2011; 80 (4): 1151-1157

    Abstract:

    To evaluate the incidence and prognostic factors for regional failure, with attention to the in-transit pathways of spread, in children with nonmetastatic rhabdomyosarcoma of the extremity.The Intergroup rhabdomyosarcoma studies III, IV-Pilot, and IV enrolled 226 children with rhabdomyosarcoma of the extremity. Failure at the in-transit (epitrochlear/brachial and popliteal) and proximal (axillary/infraclavicular and inguinal/femoral) lymph nodes was evaluated. The median follow-up for the surviving patients was 10.4 years.Of the 226 children, 55 (24%) had clinical or pathologic evidence of either in-transit and/or proximal lymph node involvement at diagnosis. The actuarial 5-year risk of regional failure was 12%. The prognostic factors for poor regional control were female gender and lymph node involvement at diagnosis. In the 116 patients with a distal extremity primary tumor, 5% had in-transit lymph node involvement at diagnosis. The estimated 5-year incidences of in-transit and proximal nodal failure was 12% and 8%, respectively. The in-transit failure rate was 0% for patients who underwent radiotherapy and/or underwent lymph node sampling of the in-transit nodal site but was 15% for those who did not (p = .07). However, the 5-year event-free survival rate did not differ between these two groups (64% vs. 55%, respectively, p = .47).The high incidence of regional involvement necessitates aggressive identification and treatment of regional lymph nodes in patients with rhabdomyosarcoma of the extremity. In patients with distal extremity tumors, in-transit failures were as common as failures in more proximal regional sites. Patients who underwent complete lymph node staging with appropriate radiotherapy to the in-transit nodal site, if indicated, were at a slightly lower risk of in-transit failure.

    View details for DOI 10.1016/j.ijrobp.2010.03.050

    View details for Web of Science ID 000292486200027

    View details for PubMedID 20542386

Stanford Medicine Resources:

Footer Links: