Lymphography in bone and soft tissue sarcomas. Experiences from three institutions.

The case material was collected from 3 Institutions with a total of 441 patients: 217 with primary bone tumor and 224 with soft tissue sarcomas. In the majority of patients lymphography was performed during the initial diagnostic workup. The lymphograms were interpreted as negative or positive for metastases. In bone tumors, the incidence of metastases was 21%, ranging from 28% for osteosarcoma to 18% for Ewing's sarcoma and 13% for chondrosarcoma. In tumors of the soft tissue, the frequency was somewhat higher (28%), with special regard to rhabdomyosarcoma (53%), anaplastic sarcoma (67%), neurogenic sarcoma (42%) and synovial sarcoma (35%). In the group of bone sarcomas, primary hematogenous spread was 3 times more frequent than lymphogenous spread, while in soft tissue sarcomas, with a higher incidence of lymphatic spread, this finding was inverted. In the more consistent tumor groups, the occurrence of lymphatic metastases indicated a significant worsening of the prognosis. In 96 patients, lymph node biopsies were performed and the radiologic histologic correlation gave evidence of a 97.7% overall diagnostic accuracy.