Lymph Node Metastases in Soft Tissue Sarcomas

Lymph node metastases are uncommon in soft tissue sarcomas, occurring in about 5% of cases. The sarcomas that most frequently metastasize to lymph nodes in adults include: Angiosarcoma, rhabdomyosarcoma (embryonal variant), and epithelioid sarcoma (the order varies depending on the study).

Synovial, clear cell, and alveolar soft part sarcomas were previously thought to have high rates of lymph node metastases, but this has not found to be the case in larger case series.

The sarcomas that account for the most lymph node metastases due to their relatively higher prevalence are leiomyosarcoma and pleomorphic undifferentiated sarcoma (formerly malignant fibrous histiocytoma).

Regional lymph node involvement is a poor prognostic factor. In addition, patients with isolated regional lymph node involvement at diagnosis have a poorer outcome than patients who develop isolated regional lymph node involvement later in the course of their disease.

References

• Behranwala KA, A'Hern R, Omar AM, Thomas JM. Prognosis of lymph node metastasis in soft tissue sarcoma. Ann Surg Oncol. 2004 Jul;11(7):714-9.
• Fong Y, Coit DG, Woodruff JM, Brennan MF. Lymph node metastasis from soft tissue sarcoma in adults. Analysis of data from a prospective database of 1772 sarcoma patients. Ann Surg. 1993 Jan;217(1):72-7.