TY - JOUR
T1 - Prognostic variables in pediatric rhabdomyosarcoma before and after multi-modal therapy
AU - Neifeld, James P.
AU - Maurer, Harold M.
AU - Godwin, David
AU - Berg, John W.
AU - Salzberg, Arnold M.
PY - 1979/12
Y1 - 1979/12
N2 - Three hundred and eighty-five patients with histologically diagnosed rhabdomyosarcoma, below the age of 19, treated prior to organized combined modality therapy were reported to the End Results Section of the National Cancer Institute. This group was compared to 524 prospectively investigated patients treated in the Intergroup Rhabdomyosarcoma Study with a coordinated program of surgery, radiation, and chemotherapy. Historically, patients with alveolar and embryonal rhabdomyosarcoma had identical survival curves. Currently, group I patients (localized disease, completely resected) with alveolar histology have an increased relapse rate as compared to other cell types. Historically there was no effect of sex on survival; currently group II (microscopic residual tumor) and group III (gross residual tumor) patients show a decreased survival in females. Extremity tumors historically had a favorable prognosis; although prognosis has improved with therapy, genitourinary and orbital tumors now have a more favorable prognosis than extremity tumors. Extent of disease at initial presentation correlated with survival in both groups of patients. It thus appears that combined modality therapy may be altering the course of rhabdomyosarcoma in children. Females, patients with alveolar histology, and extremity tumors may require more aggressive therapy because their improvement in relapse free survival is less than in males, patients with nonalveolar histology, or patients with primary genito-urinary tumors.
AB - Three hundred and eighty-five patients with histologically diagnosed rhabdomyosarcoma, below the age of 19, treated prior to organized combined modality therapy were reported to the End Results Section of the National Cancer Institute. This group was compared to 524 prospectively investigated patients treated in the Intergroup Rhabdomyosarcoma Study with a coordinated program of surgery, radiation, and chemotherapy. Historically, patients with alveolar and embryonal rhabdomyosarcoma had identical survival curves. Currently, group I patients (localized disease, completely resected) with alveolar histology have an increased relapse rate as compared to other cell types. Historically there was no effect of sex on survival; currently group II (microscopic residual tumor) and group III (gross residual tumor) patients show a decreased survival in females. Extremity tumors historically had a favorable prognosis; although prognosis has improved with therapy, genitourinary and orbital tumors now have a more favorable prognosis than extremity tumors. Extent of disease at initial presentation correlated with survival in both groups of patients. It thus appears that combined modality therapy may be altering the course of rhabdomyosarcoma in children. Females, patients with alveolar histology, and extremity tumors may require more aggressive therapy because their improvement in relapse free survival is less than in males, patients with nonalveolar histology, or patients with primary genito-urinary tumors.
KW - Rhabdomyosarcoma
UR - http://www.scopus.com/inward/record.url?scp=0018622536&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=0018622536&partnerID=8YFLogxK
U2 - 10.1016/S0022-3468(79)80248-1
DO - 10.1016/S0022-3468(79)80248-1
M3 - Article
C2 - 551147
AN - SCOPUS:0018622536
SN - 0022-3468
VL - 14
SP - 699
EP - 703
JO - Journal of pediatric surgery
JF - Journal of pediatric surgery
IS - 6
ER -