Lymph node metastases in paediatric and young adult patients with non-rhabdomyosarcoma soft tissue sarcoma (NRSTS): Findings from Children’s Oncology Group (COG) study ARST0332

Alvarez E, He J, Spunt SL, Hayes-Jordan A, Kao SC, Parham DM, Million L, Weiss AR, Barkauskas DA. Lymph node metastases in paediatric and young adult patients with non-rhabdomyosarcoma soft tissue sarcoma (NRSTS): Findings from Children’s Oncology Group (COG) study ARST0332. Eur J Cancer. 2023 Feb;180:89-98. doi: 10.1016/j.ejca.2022.11.014. Epub 2022 Nov 25. PubMed PMID: 36566574; PubMed Central PMCID: PMC9940640.

To better define the clinical features and outcomes of young patients with non-rhabdomyosarcoma soft tissue sarcoma (NRSTS) with regional and distant lymph node (LN) metastases treated in a standardized fashion, we analyzed lymph node involvement in COG study ARST0332, which evaluated a risk-based treatment strategy for young patients with all stages of NRSTS. Patients <30 years old with newly diagnosed NRSTS and LN metastases enrolled on ARST0332 were studied. Regional LN sampling was required for those with epithelioid sarcoma, clear cell sarcoma, or clinically/radiographically enlarged LNs. Tumor features and extent of pre-enrollment resection determined treatment, including chemotherapy, radiotherapy, and delayed surgery. Recommendations for LN metastases included LN dissection at the time of primary tumor resection and dose-adapted radiotherapy based on extent of LN resection.