Regional lymph node XXXX in @entity1 with soft tissue @entity242 of the extremities, what are the therapeutic consequences?

@entity1 @entity242 @entity5 @entity1600 @entity1492 @entity3 @entity1821
In the period 1977-1983, 183 adult @entity1 with soft tissue @entity242 of the extremities were treated in the Netherlands Cancer Institute. One hundred and seventy-one @entity1 had initially operable @entity5 . Fifteen @entity1 (8.2%) developed @entity1600 ( @entity1600 ) during the course of their disease. Only two @entity1 (1.2%) developed @entity1600 as first site of @entity5 recurrence. The incidence of @entity1600 varied according to the histological subtypes: @entity1821 : 1/64, @entity1492 : 1/12, @entity242 : 5/24, unclassifiable @entity242 : 3/8. The outcome in @entity1 with @entity1600 was invariably fatal. In all cases with RNLM distant @entity3 were present either at the time @entity1600 were found or shortly afterwards (median 4 months). Based on this experience we now consider @entity1600 in soft tissue @entity242 an expression of systemic @entity5 spread, which should be treated as such. We find no indication for elective lymph node dissection as part of the initial treatment of soft tissue @entity242 of any histological subtype. Therapeutic lymph node dissection might be indicated as part of the palliative management.
