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Pelvic lymph node dissection via a totally extraperitoneal approach for rhabdomyosarcoma : a case series
Ge junjie
Shandong Cancer Hospital and Institute, Shandong First Medical University and Shandong Academy of Medical Sciences
Background: Rhabdomyosarcoma (RMS)is the most common soft tissue sarcoma in children. Metastases to pelvic lymph nodes are not rare. Herein, we reported a case series of RMS patients with pelvic lymph node metastases operated on pelvic lymph node dissection(PLND) based on a totally extraperitoneal(TEP) approach to evaluate the safety and effectiveness of this technique.
Method: In this single-institutional study, thirteen consecutive RMS patients with pelvic lymph node metastases between August 2022 and August 2024were enrolled. All pelvic lymph node were managed by the TEP PLND technique.
Result: Thirteen patients (2 females and 11 males) who underwent surgery were enrolled in the current study. The median age of patients was 7.91 years (0.83–18). Surgical treatment was successful in all patients, and the median operative time and bleeding volume were 150.23 (43–360) min and 20.7 (5–100) ml, respectively. None of the patients experienced post-operative complications except for one patient who experienced swelling of right lower limb, which resolved within 6 months, and Another patient with pelvic cyst was confirmed by MRI 2 months after operation. During a median follow-up of 15 months (5–28), none of the patients exhibited recurrence or persistent disease except for 2 patients with tumor metastasis and progression.
Conclusion: The TEP PLND was technically feasible and reliable, with less invasiveness for RMS patients with PLND metastases. Future studies are needed to accumulate more experience, investigate the indications of the technique, and determine the long-term oncological safety.