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2022 Dec 9;14(24):6060. doi: 10.3390/cancers14246060. Consistent with current literature stating that PRMS is mainly a subtype seen in adults-RMS patients, it was also the most common histological subtype in our study. With regard to adult RMS, much of the published literature is from single-institution series which report on clinical parameters and survival data for adults with RMS. Cancers (Basel). Journal of clinical oncology : official journal of the American Society of Clinical Oncology. Of the patients with localised disease who were treated with one modality (n=11), nine underwent surgery (73%). *Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, NY, Department of Pediatrics, Memorial Sloan-Kettering Cancer Center, New York, NY, Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, NY, Department of Medicine, Memorial Sloan-Kettering Cancer Center, New York, NY, Department of Epidemiology & Biostatistics, Memorial Sloan-Kettering Cancer Center, New York, NY. The disease stage was determined by X-ray, CT, MRI, or PET-CT. The 5-year rate of overall survival (OS) was 45% for patients with nonmetastatic disease. However, chemotherapy regimen for non-metastatic patients was not significant on univariate analysis for overall survival (p=.14). Careers. Prognosis and survival depend on many things. Overall survival (OS), local failure (LF), and distant metastasis (DM) were the endpoints used in this study. 553563, 2013. J Pediatr Hematol Oncol. official website and that any information you provide is encrypted 4556, 2013. Age itself has previously been associated with poor disease outcomes, as IRS-V study reported a significantly improved 3-year failure-free survival rate among children less than ten years of age [7]. T. D. Fischer, S. G. Gaitonde, B. C. Bandera et al., Pediatric-protocol of multimodal therapy is associated with improved survival in AYAs and adults with rhabdomyosarcoma, Surgery, vol. Local failure did not differ between patients treated with surgery vs. definitive radiation treatment (p=.37). The median age was 46.5 years with a range of 1878, while 55% of patients were 40 years or older. 215223, 2001. Of the patients who received radiation to their primary tumors, the median radiation dose was 50.4Gy (range: 10Gy70.3Gy). A recent study from the Childrens Oncology Group (COG) investigated this hypothesis by exploring the rates of adverse events in the IRS-IV study by age and treatment regimen. Yang J, Gao J, Hu J, Hu W, Qiu X, Huang Q, Kong L, Lu JJ. Federal government websites often end in .gov or .mil. PDF About Rhabdomyosarcoma - American Cancer Society {currentyear} American Cancer Society, Inc. All rights reserved. Ognjanovic S, et al. Rhabdomyosarcoma (RMS) is a type of sarcoma made up of cells that normally develop into skeletal (voluntary) muscles. As of December 31, 2021, at a median survivor follow-up of 3.3 years (range, 0.1-5.8 years), the 3-year event-free survival for all patients in the intent-to-treat analysis was 52.5% (95% CI, 34.8 to 70.2) for regimen A and 50.6% (95% CI, 32 to 69.2) for regimen B ( P = .8677, log-rank test); the 3-year overall survival was 75.7% (95% CI, 59.7 t. For any patient with rhabdomyosarcoma, we will determine if there are clinical trials open and help patients and families understand the variety of treatment options available.. RMS can arise in many different sites throughout the body and is classified into three major histological subtypes: pleomorphic rhabdomyosarcoma (PRMS), embryonal rhabdomyosarcoma (ERMS), and alveolar rhabdomyosarcoma (ARMS). The tumor site was unfavorable in 67% of patients. Patients treated according to a protocol were designated as such at time of treatment. We did not find any difference in overall survival between patients treated before and after 2000, which might be due to patient demographics, tumour characteristics, and lack of evolution in treatment strategies. Therefore, it has been questioned whether rhabdomyosarcoma patients could benefit from molecularly targeted and immunotherapeutic approaches, potentially reducing the treatment-associated toxicities caused by current chemotherapy and radiation therapy [19, 21]. The remaining cases may be elsewhere, including within the trunk of the body. The .gov means its official. The current therapeutic approaches for newly diagnosed paediatric patients are outlined in the Intergroup Rhabdomyosarcoma Study Group-V (IRS-V) study and European paediatric Soft tissue sarcoma Study Group (EpSSG), in which a multidisciplinary risk-adapted treatment is recommended [6]. and transmitted securely. In terms of other prognostic factors that predict for better outcomes in adults, we found that the predictors of better outcome in children were similar to those found in adults, such as low-risk group, favorable histology, and favorable primary site, all of which were significant on univariate analysis for OS, though histology lost significance on MVA for the entire cohort and primary site and histology lost significance on MVA in non-metastatic patients. Principles and Practice of Pediatric Oncology. This site needs JavaScript to work properly. Accessibility Rhabdomyosarcoma accounts for about 3% of cancer cases among children. Philadelphia, Pa: Lippincott Williams & Wilkins; 2016. official website and that any information you provide is encrypted Cumulative incidence curves of LF and DM were compared using Grays method. Alveolar rhabdomyosarcoma (ARMS) affects all age groups and is found more often in the arms, legs, or trunk (chest or abdomen). See this image and copyright information in PMC. 56% of the patients (n=18) with localised disease were treated with a combination of more than two of the following modalities: surgery, chemotherapy, and radiotherapy. doi: 10.1016/j.ijrobp.2012.08.019. The protocols on which some patients were enrolled include both national protocols such as the COG protocol ARST 0331 and XXXXXXXX protocols designed for patients with RMS. A retrospective analysis of 171 patients treated at a single institution. However, our study also included a lower percentage of adults with unfavorable histologies (47% unfavorable) which is in contrast to the SEER data where 79% of adults had unfavorable histologies as compared to 42% of children. These four patients presented with an unfavourable histologic subtype, and three-quarters had metastatic disease with pulmonary involvement. 915, 2001. 35053511, 2008. Moreover, histologic subtype did vary according to anatomic site and age in agreement with previously published reviews. Eight patients had a local relapse at the primary tumour site; two had a local relapse the regional site; and eleven (52%) patients had metastatic relapses. 62136217, 2015. Doctors arent sure what causes rhabdomyosarcoma. American Cancer Society medical information is copyrightedmaterial. Results Conclusions Summary This study was conducted in a large retrospective series of adult patients with rhabdomyosarcoma (RMS). Embryonal rhabdomyosarcoma had the highest 5-year survival rate (73.9%). Adults; Childhood tumors in adults; Multimodal treatment; Rhabdomyosarcoma; Soft tissue sarcoma; Treatment score. Five-year overall survival rates from single-institution studies were in the range of 21% to 53% (Table 1). However, for a subset of non-metastatic patients treated on prospective RMS protocols, survival is significantly improved and approaches survival rates seen in the pediatric population. Short statue is typically diagnosed when a child's height is two standard deviations from the mean for his or her age and gender. . Clinical and pathological characteristics, treatment outcome and prognostic factors in adult rhabdomyosarcoma: a monocentric retrospective study. eCollection 2022. Among patients with non-metastatic disease (n=94), significant factors associated with OS were histology, site, risk group, age, and protocol treatment. Therefore, all patients under 18 were excluded from the study (n=35), as 17 years of age is the cut-point used at our institution for paediatric patients. The remainder of patients was treated with other regimens including ifosfamide and doxorubicin and mesna, doxorubicin, ifosfamide, and dacarbazine (MAID). However, people may be more likely to develop this form of cancer if they have inherited gene mutations such as: The genetic mutations associated with these conditions may allow abnormal cells to multiply, leading to tumor development. Raney RB, Anderson JR, Barr FG, Donaldson SS, Pappo AS, Qualman SJ, Wiener ES, Maurer HM, Crist WM. 1, pp. The reasons are likely multifactorial and may include overrepresentation of pleomorphic rhabdomyosarcoma, limited access to clinical trials, and poor adherence to aggressive treatment regimens. Prognosis is the chance of recovery. 5, no. Plus, boxer and cancer survivor Bridgett Riley. Treatment. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final citable form. 2009 Mar 20;27(9):1446-55. doi: 10.1200/JCO.2007.15.0466. Five-year OS was 15% in the subgroup of 20 patients with metastatic disease and increased to 40% for patients within the subgroup who presented with localised disease at the time of diagnosis (Figure 2). Only a doctor familiar with a child's medical history, the type, stage and characteristics . On univariate analysis, younger age (p=.02), lower risk group (p=.01), embryonal histology (p=.04), favorable primary site (p=.02), and protocol participation (p=.03) were associated with improved overall survival (Table 2). Three patients had a second relapse. Many of these signs and symptoms are more likely to be caused by something other than RMS. It has been suggested that this disparity may be related to biological and/or treatment-related factors, which in the literature has been shown to be distributed differently among paediatric and adult patients. On multivariate analysis, risk group and protocol treatment were significant after adjusting for age. 794803, 2001. 2001 May;23(4):215-20. doi: 10.1097/00043426-200105000-00008. The authors declare no conflicts of interest. Unable to load your collection due to an error, Unable to load your delegates due to an error. Rhabdomyosarcoma (RMS) is a pediatric sarcoma rarely occurring in adults. 3, pp. 2000 Feb 2;92(3):205-16 Median age was 28 (range 1686) years. Atlanta, Ga: American Cancer Society; 2020. 557565, 1983. Treatment for Rhabdomyosarcoma - American Cancer Society Because of these factors, adults are already from the time of diagnosis assigned to high-risk and very high-risk groups with inferior prognoses according to EpSSG [6]. Because of the small number of patients with ARMS, we did not analyse whether younger patients with ERMS versus ARMS had a statistically better outcome, but we believe that younger patients with favourable histological subtypes theoretically would most likely have better outcomes. 19 Citations Metrics Abstract Rhabdomyosarcoma (RMS) is rare in adults and it is generally characterized by poor outcome. COG risk group was defined according to COG guidelines. Rhabdomyosarcoma > Fact Sheets > Yale Medicine Camero S, Cassandri M, Pomella S, Milazzo L, Vulcano F, Porrazzo A, Barillari G, Marchese C, Codenotti S, Tomaciello M, Rota R, Fanzani A, Megiorni F, Marampon F. Front Oncol. Dantonello TM, Int-Veen C, Harms D, Leuschner I, Schmidt BF, Herbst M, Juergens H, Scheel-Walter HG, Bielack SS, Klingebiel T, Dickerhoff R, Kirsch S, Brecht I, Schmelzle R, Greulich M, Gadner H, Greiner J, Marky I, Treuner J, Koscielniak E. J Clin Oncol. RMS is the most common pediatric sarcoma and large, multi-institutional trials have detailed its biologic and clinical characteristics. Unable to load your collection due to an error, Unable to load your delegates due to an error. December 01, 2016 Adult rhabdomyosarcoma survivor learns to appreciate every day BY Cynthia DeMarco Fort Worth resident Susan Pratt was playing tennis in June 1995, when she realized she couldn't feel the left side of her gum line. 3, pp. We can connect you with trained cancer information specialists who will answer questions about a cancer diagnosis and provide guidance and a compassionate ear. Saadi M, Letaief F, Gabsi A, Mokrani A, Meddeb K, Mezlini A. Pan Afr Med J. 6, p. 27, 2015. 8, pp. Three of these patients had embryonal histology and one had alveolar histology. During a physical examination, doctors will examine the body part that has been exhibiting symptoms and feel any mass, if present, to note its size and texture. Pomella S, Porrazzo A, Cassandri M, Camero S, Codenotti S, Milazzo L, Vulcano F, Barillari G, Cenci G, Marchese C, Fanzani A, Megiorni F, Rota R, Marampon F. Int J Mol Sci. Kaplan Meier overall survival stratified by disease status. The study included 95 consecutive patients (age 18-77 years) treated from 2002 to 2015 for embryonal and alveolar RMS. Kaplan Meier Overall Survival stratified by protocol for non-metastatic patients. 20, pp. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain. Rhabdomyosarcoma in adults. Aarhus University Hospital is one of the two tertiary sarcoma centers located in Denmark and a European reference center for sarcomas. E. Bompas, L. Campion, A. Italiano et al., Outcome of 449 adult patients with rhabdomyosarcoma: an observational ambispective nationwide study, Cancer Medicine, vol. Although the adult OS rate of 27% was lower than the 31%44% in the retrospective studies cited above and the pediatric OS rate of 61% was lower than historical controls of 70%80% [5,16], this study nonetheless provided comparative survival data from large numbers of adult and pediatric patients that demonstrated that adults had considerably lower survival rates than children. Stage 1 The tumor started in a favorable area: The orbit (area around the eye) The head and neck area, except for parameningeal sites (areas next to the membranes covering the brain, such as the nasal passages and nearby sinuses, middle ear, and the uppermost part of the throat) A genital or urinary site, except the bladder or prostate gland No patients were lost to follow-up. 12, pp. The 5-year survival rate for teens ages 15 to 19 is 50%. 2013 May 1; 86(1): 5863. 16, no. C. Chen, H. Dorado Garcia, M. Scheer, and A. G. Henssen, Current and future treatment strategies for rhabdomyosarcoma, Frontiers in Oncology, vol. Chapter 31: Rhabdomyosarcoma. L. Bergamaschi, R. Bertulli, M. Casanova et al., Rhabdomyosarcoma in adults: analysis of treatment modalities in a prospective single-center series, Medical Oncology, vol. The American Cancer Society is a qualified 501(c)(3) tax-exempt organization. Five-year overall survival from single institution studies were in the range of 31% to 44% [1,6,7,9,11]. 33 patients (24%) were low risk, 61 (44%) intermediate risk, and 44 (32%) high risk. This retrospective cohort study included 50 adults in the age range of 1878 years diagnosed with rhabdomyosarcoma, who were registered in the population-based Aarhus Sarcoma Registries from 1979 to 2018. We subgrouped the cohort according to the different treatment modalities. Patients receiving multimodality treatment were on average younger than those who did not (mean age, 40 versus 51 years). 46% were treated on or according to a prospective RMS protocol. Embryonal tumors were present in 74 patients (54%), alveolar in 45 patients (33%), pleomorphic in 16 patients (12%), and NOS in 3 patients (2%). However, the survival rate varies widely depending on the tumor type, tumor location, surgery results, stage and risk group, and the child's age. OS was compared using the log-rank test for categorical variables and Cox proportional hazards regression model for continuous variables. Published 31 Aug 2021 Abstract Introduction. Signs and Symptoms of Rhabdomyosarcoma | American Cancer Society and transmitted securely. Adults who are diagnosed with rhabdomyosarcoma tend to have a poorer outcome than children do, often because the cancer grows more quickly and may be located in difficult-to-treat body parts. The majority of the patients in the cohort (n=38, 76%) underwent surgical resection. In about 31% of cases, the cancer is located within the urinary tract, including the bladder, prostate, or vagina. Treatment of rhabdomyosarcoma varies depending on the location, size, and genetic features of the tumor, says Juan Vasquez, MD, assistant professor of pediatrics (hematology/oncology) at Smilow Cancer Hospital. 1, pp. National Library of Medicine FOIA The median age was 46.5 years, and the median overall survival was 2.3 years. The 5-year EFS was 40.8% for patients with the highest treatment score, and 15% for those with lower score, while OS was 44.4% and 24.5%, respectively. Embryonal and Alveolar Rhabdomyosarcoma in Adults: Real-Life - PubMed We therefore captured an older age group than the adolescent population studied in IRS IV in which all patients were < 21 or in the Italian STSC study which included patients 18. Little et al. The data are not available due to ethical restrictions. On a similar note, various authors have reported that adults with rhabdomyosarcoma tended to be treated with various chemotherapy regimens (ranging from multiagent paediatric chemotherapy schedules to single-agent doxorubicin), reflecting a lack of consensus on a standardised approach to adult rhabdomyosarcoma [2, 3]. The heterogeneity in the management of rhabdomyosarcoma may have affected the outcome of the studied patients. For patients receiving chemotherapy, the mean follow-up time was 40 months and 65 for those who did not. I. Sultan, I. Qaddoumi, S. Yaser, C. Rodriguez-Galindo, and A. Ferrari, Comparing adult and pediatric rhabdomyosarcoma in the surveillance, epidemiology and end results program, 1973 to 2005: an analysis of 2,600 patients, Journal of Clinical Oncology, vol. In the IRS-IV series, patients age 10 or greater with non-metastatic disease had a 3-year FFS rate of 68% which is comparable to our 3-year OS rate of 71% [5]. Rhabdomyosarcoma in Adults: A Retrospective Analysis of Case Records Radioresistance in rhabdomyosarcomas: Much more than a question of dose. This could also be the explanation for why patients receiving surgery and radiation therapy performed better than patients treated with surgery alone or multimodal therapy. Adult Rhabdomyosarcoma Survival Improved With Treatment on Children aged 1 to 9 tend to have a better outlook than infants or older children or adults. Three patients were only treated with one modality, either chemotherapy or surgical resection of the primary tumour. 2004 Jun;42(7):618-25. doi: 10.1002/pbc.20012. In a phase 2 trial of pazopanib in patients with soft tissue sarcomas conducted by the European Organization for Research and Treatment of Cancer-soft tissue and bone sarcoma group (EORTC), prolonged progression-free survival (PFS) and OS were observed compared to those for the controls [ ]. If they suspect that the mass may be cancerous, doctors will order one or more of the following imaging tests: If the imaging study confirms the presence of a mass or lump, the doctors will biopsy the tissue to make a formal diagnosis. Crist W, et al. This group found that among patients with high scores for appropriate treatment, 5-year OS was 61% [7]. The absence of distant metastases defined the localised disease. Meza JL, Anderson J, Pappo AS, Meyer WH; Children's Oncology Group. Orbital involvement is one of the most favorable factors in children, and the 5-year survival rate is >90%. Treatment strategies and outcomes for spinal rhabdomyosarcoma: A series of 11 cases in a single center and review of the literature. J Clin Oncol. [12] and Khosla et al. Rhabdomyosarcoma - Wikipedia Notably, the fusion-positive cases have shown a relationship with higher age at diagnosis and have a low prognostic significance [6, 21]. This left 50 patients eligible for the study. [15] demonstrated a better survival and local control in adults treated with multimodality therapy on lines of paediatric rhabdomyosarcoma but also raised the question of whether adults might tolerate treatments designed for children to a lesser degree [12]. The cohort included 50 patients, 18 years of age and older, with a reported diagnosis of rhabdomyosarcoma. UpToDate. The reason for the low percentage of patients receiving chemotherapy in our study (54%) (Table 5) could be the predominance of pleomorphic subtype in our cohort (44%), as the majority of this subgroup would be treated as nonrhabdomyosarcoma with surgery only or with a combination of radiotherapy, as pleomorphic rhabdomyosarcoma has been shown not to be as responsive to chemotherapy as the embryonal or alveolar subtypes [18, 22]. The https:// ensures that you are connecting to the On MVA for overall survival, patients 44 not on protocol experienced significant shorter OS (HR 2.16, 95% CI 1.044.49, p=.04) than patients of the same age group treated on protocol. sharing sensitive information, make sure youre on a federal Forty-six percent were treated on or according to a prospective RMS protocol. These are the cells that can develop into RMS. There could be comorbid diseases and loss of organ function explaining the pattern of use [23]. For rhabdomyosarcoma that is located in the arms or legs, surgery is often used to remove the tumor. -, Cancer. If RMS becomes more advanced, it can cause symptoms such as lumps under the skin (often in the neck, under the arm, or in the groin), bone pain, constant cough, weakness, or weight loss. 2, pp. 91, no. Rhabdomyosarcoma is a rare sarcoma that develops in the muscles and can cause pain and swelling. These findings are aligning with our results, as the primary tumour was mainly located in the extremities, accounting for 44% of our cases. Pleomorphic rhabdomyosarcoma was the most common histologic subtype, accounting for 22 patients (median age, 54 years; range 1877). Similarly, for primary site, favorable primary site included genitourinary (non-bladder or prostate), head and neck (non-parameningeal), and orbit. Sarcomas across the age spectrum. Trends in childhood rhabdomyosarcoma incidence and survival in the united states, 19752005. Please enable it to take advantage of the complete set of features! 2022 Sep 29;12:1016894. doi: 10.3389/fonc.2022.1016894. Outcomes for children and adolescents with cancer: Challenges for the twenty-first century. A mass or bleeding in the vagina or rectum If the cancer is in the arms or legs, signs and symptoms may include, among others: Swelling or a lump in the arm or leg Pain in the affected area, though sometimes there is no pain Request an appointment Get Mayo Clinic cancer expertise delivered to your inbox. In patients with localized disease, OS rates were similar (77% versus 79%). Tel: 212 639 5148; Fax: 212 639 2417; The publisher's final edited version of this article is available at, rhabdomyosarcoma, adolescents, adults, soft tissue sarcoma, age. As a result, 5-year survival rates increased from 25% in 1970 to 73%, as shown in the Intergroup Rhabdomyosarcoma Study (IRS)-IV reported in 2001. Rhabdomyosarcoma is a type of soft tissue cancer that develops in cells that were intended to develop into skeletal muscle tissue. Data suggests that, for every 1-year increase in age, the risk of death is increased by a factor of 1.015. Survival Rhabdomyosarcoma is a kind of sarcoma cancer of soft tissue, connective tissue, or bone. Roughly 25% of the time, rhabdomyosarcoma is found in the head or neck. After a diagnosis of rhabdomyosarcoma, the stage (extent) and risk group of the cancer provide important information about the anticipated response to treatment. There are limitations regarding the reliability of all register-based studies, but Aarhus Sarcoma Registers are reported to be a valuable population-based tool for epidemiological research [24]. This makes it difficult to compare data on paediatric and adult RMS, as there is a disproportional incidence of PRMS in adults [17]. Due to the nature of this research, participants of this study did not agree for their data to be shared publicly and it could compromise research participants privacy and consent. Adult Rhabdomyosarcoma Survival Improved with Treatment on Nevertheless, the primary tumour location is still clinically meaningful, as tumours occurring in, for example, the retroperitoneum, can become quite large before producing signs and symptoms [22]. This could introduce bias and a deviation of the observed overall survival rates and consequently threaten the internal validity of the estimates. Since protocol patients tended to be younger than non-protocol patients, (mean age of protocol patients 22 vs. 43 for non-protocol patients), patients were stratified as age 44 on protocol and age 44 not on protocol thereby controlling the difference in age between the two groups. External beam radiation therapy was included in the treatment of 24 patients. Key Statistics for Rhabdomyosarcoma | American Cancer Society Patients still alive at the end of the study or lost to follow-up were censored at the last follow-up date. One explanation for the lower survival rates seen in adults is an increased incidence of adverse prognostic factors such as unfavourable primary sites and higher rates of regional and distant spread . 8600 Rockville Pike Publisher's Disclaimer: This is a PDF file of an unedited manuscript that has been accepted for publication. Variables with p-values <0.10 on univariate analysis were considered in the MVA. St. Jude What is rhabdomyosarcoma? Rhabdomyosarcoma is a type of soft tissue cancer that develops in cells that were intended to develop into skeletal muscle tissue. There were no differences between non-metastatic protocol patients and non-protocol patients with regard to risk group (low vs. intermediate), KPS, histology (favorable vs. unfavorable), and primary site (favorable vs. unfavorable) (table 3). Analysis of prognostic factors in patients with nonmetastatic rhabdomyosarcoma treated on intergroup rhabdomyosarcoma studies III and IV: the Children's Oncology Group. What could such symptoms as a bulging mass growing behind an eye, a growth on the testicles, and a painless lump on the leg have in common? For the purposes of statistical analyses, histology was classified as favorable and unfavorable with embryonal classified as favorable and alveolar, pleomorphic, and not otherwise specified (NOS) classified as unfavorable. Methods and materials: The overall rate of response to chemotherapy was 85%. Baseline clinical characteristics at diagnosis of localised or metastatic disease. Currently, the five-year overall survival rates have increased to around 70% for children with the nonmetastatic disease [2, 7]. Before One-year survivor of adult alveolar rhabdomyosarcoma of the - LWW 163, no. Bethesda, MD 20894, Web Policies 8600 Rockville Pike Kaplan Meier Overall Survival stratified by protocol for non-metastatic patients. For example, children with embryonal rhabdomyosarcoma (ERMS) and limited spread (to only 1 or 2 distant sites) have a higher 5-year survival rate. Rhabdomyosarcoma in adults: analysis of treatment modalities - Springer Five-yr OS was 54% for protocol patients vs 36% for non-protocol patients. National survival trends of young adults with sarcoma: Lack of progress is associated with lack of clinical trial participation. [3] It is generally considered to be a disease of childhood, as the vast majority of cases occur in those below the age of 18. 2023 Jun 21;30(7):5953-5972. doi: 10.3390/curroncol30070445. Thank you to Lawrence A. Herman for his editorial assistance with this manuscript. The 5-year EFS was 40.8% for patients with the highest treatment score, and 15% for those with lower score, while OS was 44.4% and 24.5%, respectively. 46% were treated on or according to a prospective RMS protocol. Analysis of prognostic factors of pediatric-type sarcomas in adult patients. 7th ed. Cancer. Please enable it to take advantage of the complete set of features! Rhabdomyosarcoma in children differs from the form of the disease typically seen in adults. Int J Radiat Oncol Biol Phys. [ 1, 2] In more recent years, improvements in outc. Prospective studies looking at CNS directed prophylactic therapies are warranted given the high rates of CNS failure seen in adults with parameningeal RMS. The results of the current study indicate that adults with RMS have increased rates of poor prognostic features such as unfavorable primary site. Rhabdomyosarcoma (RMS) is a rare malignancy, with an incidence of 4.5 per million people younger than 20 years in the United States. government site. Significant factors associated with inferior overall survival were histology and disease stage, although histological subtype was not significant in the multivariate model.