Parameningeal rhabdomyosarcoma in pediatric age: results of a pooled analysis from North American and European cooperative groups
- 1 January 2014
- journal article
- research article
- Published by Elsevier BV in Annals of Oncology
- Vol. 25 (1), 231-236
- https://doi.org/10.1093/annonc/mdt426
Abstract
Parameningeal (PM) site is a well-known adverse prognostic factor in children with localized rhabdomyosarcoma (RMS). To identify risk factors associated with outcome at this site, we pooled data from 1105 patients treated in 10 studies conducted by European and North American cooperative groups between 1984 and 2004. Clinical factors including age, histology, size, invasiveness, nodal involvement, Intergroup Rhabdomyosarcoma Study (IRS) clinical group, site, risk factors for meningeal involvement (MI), study group, and application of radiotherapy (RT) were studied for their impact on event-free and overall survival (EFS and OS). Ten-year EFS and OS were 62.6 and 66.1% for the whole group. Patients without initial RT showed worse survival (10-year OS 40.8% versus 68.5% for RT treated patients). Multivariate analysis focusing on 862 patients who received RT as part of their initial treatment revealed four unfavorable prognostic factors: age 10 years, signs of MI, unfavorable site, and tumor size. Utilizing these prognostic factors, patients could be classified into different risk groups with 10-year OS ranging between 51.1 and 80.9%. While, in general, PM localization is regarded as an adverse prognostic factor, the current analysis differentiates those with good prognosis (36% patients with 0–1 risk factor: 10-year OS 80.9%) from high-risk PM patients (28% with 3–4 factors: 10-year OS 51.1%). Furthermore, this analysis reinforces the necessity for RT in PM RMS.Keywords
Funding Information
- National Cancer Institute
- National Institutes of Health (U10 CA98543-08, U10 CA98413-08)
- Fondazione Città della Speranza
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