Retrospective study of the surgical management and outcome of nonrhabdomyosarcoma soft tissue sarcomas of the groin and axilla in children
Received 11 November 2008; received in revised form 22 February 2009; accepted 25 February 2009.
Abstract
Purpose
The incidence of pediatric nonrhabdomyosarcoma soft tissue sarcomas (NRSTSs) of the groin and axilla is unknown, and the optimal surgical approach to these patients is unclear.
Methods
We conducted a retrospective study of patients treated at St Jude Children's Research Hospital from January 1962 to March 2007 for NRSTSs of the groin and axilla. Demographic variables, tumor pathology, clinical management, and outcome were reviewed.
Results
Of the 300 patients treated for NRSTSs, only 10 had tumors of the axilla or groin (6 of whom had synovial sarcoma). Surgical interventions included wide resection of the tumor (n = 7), marginal resection (n = 1), subtotal resection (n = 1), and biopsy only (n = 1). Six patients underwent lymph node sampling; all were negative for tumor. Short- and long-term surgical complications were rare. Four patients received adjuvant chemotherapy (n = 3) and/or radiotherapy (n = 2). At a median follow-up of 8.5 years, 7 of the 10 were surviving free of disease. Two of these patients died of tumor progression (1 with metastases at diagnosis and 1 with an unresectable tumor at diagnosis), and one patient who was free of NRSTS died of secondary breast carcinoma.
Conclusions
Pediatric NRSTSs of the axilla and groin are rare, but outcomes are similar to those of other patients with NRSTS. Wide local excision of the tumor with preservation of good limb function should be the surgical goal and may be sufficient therapy in some cases.
aDepartment of Surgery, St Jude Children's Research Hospital, Memphis, TN 38105, USA
bDepartment of Radiological Sciences, St Jude Children's Research Hospital, Memphis, TN 38105, USA
cDepartment of Oncology, St Jude Children's Research Hospital, Memphis, TN 38105, USA
dDepartment of Pediatrics, University of Tennessee School of Medicine, Memphis, TN 38105, USA
eDepartment of Pathology, St Jude Children's Research Hospital, Memphis, TN 38105, USA
fDepartment of International Outreach, St Jude Children's Research Hospital, Memphis, TN 38105, USA
Department of Oncology, St Jude Children's Research Hospital, 262 Danny Thomas Place, Memphis, TN 38105, USA. Corresponding author. Tel.: +1 901 595 3984; fax: +1 901 521 9005.
ABSTRACT