The study showed that lymph node metastases are relatively common in this form of childhood cancer in the arms and legs, which negatively affects the survival of these children. Terwisscha van Scheltinga therefore focused her research on improving the detection of lymph node metastases with as little harm to the patient as possible.
Not blue, but green
On October 24, pediatric surgeon Sheila Terwisscha van Scheltinga will receive her PhD from Utrecht University on the topic of ‘Staging of children with rhabdomyosarcoma of the extremities’. An important part of the study was the application of the sentinel lymph node procedure, a method already used in adults. A systematic review and data from the European pediatric Soft tissue Sarcoma Group (EpSSG) showed that this procedure is also suitable for children and can accurately predict lymph node status. In addition, the possibility of replacing the patent blue tracer with technetium-labeled indocyanine green was investigated. This modification was found to give the same good results with fewer long-term adverse effects of the blue dye.
International guidelines
The study eventually led to adjustments in international guidelines, with the sentinel node procedure now used to stage children with rhabdomyosarcoma. Sheila Terwisscha van Scheltinga: ‘This procedure helps to stage the cancer and allows a more targeted search for lymph node metastases. This contributes to a better risk stratification of patients, with the hope that this will lead to an improvement in survival rates in the future.’