Rhabdomyosarcoma natural history, complications and prognosis
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]
Overview
Common complications of rhabdomyosarcoma include metastasis to lung, bone marrow, and bone, cardiomyopathy, pulmonary failure, renal electrolyte wasting, acute myelogenous leukemia, secondary malignancies, and recurrent rhabdomyosarcoma. Rhabdomyosarcoma is associated with a 5 year survival rate of 72%. Adults and adolescents have worse outcome rather than children. The presence of metastasis is associated with a particularly poor prognosis. Histologically, the embryonal rhabdomyosarcoma and anatomically, the orbital and genitourinary tract rhabdomyosarcomas have the most favorable prognosis.
Complications
- Rhabdomyosarcoma may cause metastasis to other organs.[1]
- Less than 25% of patients present with distant metastases at he time of diagnosis.[2]
- The most common metastatic site is lung.
- The other metastatic sites are as following:[3][4]
- Bone marrow (30%)
- Bone (30%)
- Omentum and ascites (16%)
- Pleura (13%)
- Visceral involvement
- Brain metastases
- Patients may develop with some complications after treatment such as:[5][6]
- Cardiomyopathy
- Regarding anthracycline and cyclophosphamide use
- Pulmonary failure
- Renal electrolyte wasting
- Regarding ifosfamide use
- Acute myelogenous leukemia
- Regarding etoposide use
- Secondary malignancies
- Skin and bone tumors regarding radiotherapy
- Cardiomyopathy
- Recurrent rhabdomyosarcoma is prevalent among patients with following criteria:[7]
- Presence of gross residual disease after initial surgery located in unfavorable sites
- Lymph node involvement (N1)
- Tumor size > 5cm
- Age < 10 years
- Alveolar rhabdomyosarcoma
- Distant metastatic at diagnosis
- Long-term complications after treatment regarding to different organs are listed below:
| Affected organs | Long-term complications |
|---|---|
| Head and neck problems[8][9][10] |
|
| Bladder and bowel problems [11][12] | Bladder:
|
| Eye problems[13] | |
| Dental and facial problems[14][15] |
|
Prognosis
- Rhabdomyosarcoma prognosis are considered as a favorable one in presence of following criteria:[16][17][18]
- Adults and adolescents have worse outcome rather than children.[19][20]
- The overall 5-year survival rate is 27% in adults while it is 61% in children.
- This difference is regarding to unfavorable tumor sites, metastatic recurrence, lymph nodes involvement, and pleomorphic and NOS (not otherwise specified) rhabdomyosarcoma.[19][21]
- The overall 5-year survival rate is 27% in adults while it is 61% in children.
- The survival rate and event-free survival rate of nonmetastatic tumors are as following:[22]
| Tumors location | Overall survival rate | Event-free survival rate |
|---|---|---|
| Head and neck tumors | 64% | 35% |
| Orbit | 85% | 53% |
| Paramenigeal tumors | In age < 3 years: 59%
In age ≥ 3 years: 65% |
In age < 3 years: 33%
In age ≥ 3 year:62% |
| Genitourinary tumors ( non-bladder and prostate) | 94% | 82% |
| Genitourinary tumors ( bladder and prostate) | 80% | 64% |
| Extremities | 46% | 35% |
| Other sites | 63% | 54% |
References
- ↑ Raney RB, Tefft M, Maurer HM, Ragab AH, Hays DM, Soule EH; et al. (1988). "Disease patterns and survival rate in children with metastatic soft-tissue sarcoma. A report from the Intergroup Rhabdomyosarcoma Study (IRS)-I". Cancer. 62 (7): 1257–66. PMID 2843274.
- ↑ Koscielniak E, Rodary C, Flamant F, Carli M, Treuner J, Pinkerton CR; et al. (1992). "Metastatic rhabdomyosarcoma and histologically similar tumors in childhood: a retrospective European multi-center analysis". Med Pediatr Oncol. 20 (3): 209–14. PMID 1574030.
- ↑ Ruymann FB, Newton WA, Ragab AH, Donaldson MH, Foulkes M (1984). "Bone marrow metastases at diagnosis in children and adolescents with rhabdomyosarcoma. A report from the intergroup rhabdomyosarcoma study". Cancer. 53 (2): 368–73. PMID 6546301.
- ↑ Breneman JC, Lyden E, Pappo AS, Link MP, Anderson JR, Parham DM; et al. (2003). "Prognostic factors and clinical outcomes in children and adolescents with metastatic rhabdomyosarcoma--a report from the Intergroup Rhabdomyosarcoma Study IV". J Clin Oncol. 21 (1): 78–84. doi:10.1200/JCO.2003.06.129. PMID 12506174.
- ↑ Punyko JA, Mertens AC, Gurney JG, Yasui Y, Donaldson SS, Rodeberg DA; et al. (2005). "Long-term medical effects of childhood and adolescent rhabdomyosarcoma: a report from the childhood cancer survivor study". Pediatr Blood Cancer. 44 (7): 643–53. doi:10.1002/pbc.20310. PMID 15700252.
- ↑ Egas-Bejar D, Huh WW (2014). "Rhabdomyosarcoma in adolescent and young adult patients: current perspectives". Adolesc Health Med Ther. 5: 115–25. doi:10.2147/AHMT.S44582. PMC 4069040. PMID 24966711.
- ↑ Dantonello TM, Int-Veen C, Schuck A, Seitz G, Leuschner I, Nathrath M; et al. (2013). "Survival following disease recurrence of primary localized alveolar rhabdomyosarcoma". Pediatr Blood Cancer. 60 (8): 1267–73. doi:10.1002/pbc.24488. PMID 23418028.
- ↑ Raney RB, Asmar L, Vassilopoulou-Sellin R, Klein MJ, Donaldson SS, Green J; et al. (1999). "Late complications of therapy in 213 children with localized, nonorbital soft-tissue sarcoma of the head and neck: A descriptive report from the Intergroup Rhabdomyosarcoma Studies (IRS)-II and - III. IRS Group of the Children's Cancer Group and the Pediatric Oncology Group". Med Pediatr Oncol. 33 (4): 362–71. PMID 10491544.
- ↑ Katz JR, Bareille P, Levitt G, Stanhope R (2001). "Growth hormone and segmental growth in survivors of head and neck embryonal rhabdomyosarcoma". Arch Dis Child. 84 (5): 436–9. PMC 1718743. PMID 11316695.
- ↑ Paulino AC, Simon JH, Zhen W, Wen BC (2000). "Long-term effects in children treated with radiotherapy for head and neck rhabdomyosarcoma". Int J Radiat Oncol Biol Phys. 48 (5): 1489–95. PMID 11121653.
- ↑ Raney B, Heyn R, Hays DM, Tefft M, Newton WA, Wharam M; et al. (1993). "Sequelae of treatment in 109 patients followed for 5 to 15 years after diagnosis of sarcoma of the bladder and prostate. A report from the Intergroup Rhabdomyosarcoma Study Committee". Cancer. 71 (7): 2387–94. PMID 8453560.
- ↑ Yeung CK, Ward HC, Ransley PG, Duffy PG, Pritchard J (1994). "Bladder and kidney function after cure of pelvic rhabdomyosarcoma in childhood". Br J Cancer. 70 (5): 1000–3. PMC 2033564. PMID 7947075.
- ↑ Raney RB, Anderson JR, Kollath J, Vassilopoulou-Sellin R, Klein MJ, Heyn R; et al. (2000). "Late effects of therapy in 94 patients with localized rhabdomyosarcoma of the orbit: Report from the Intergroup Rhabdomyosarcoma Study (IRS)-III, 1984-1991". Med Pediatr Oncol. 34 (6): 413–20. PMID 10842248.
- ↑ Kaste SC, Hopkins KP, Bowman LC (1995). "Dental abnormalities in long-term survivors of head and neck rhabdomyosarcoma". Med Pediatr Oncol. 25 (2): 96–101. PMID 7603407.
- ↑ Estilo CL, Huryn JM, Kraus DH, Sklar CA, Wexler LH, Wolden SL; et al. (2003). "Effects of therapy on dentofacial development in long-term survivors of head and neck rhabdomyosarcoma: the memorial sloan-kettering cancer center experience". J Pediatr Hematol Oncol. 25 (3): 215–22. PMID 12621240.
- ↑ Joshi D, Anderson JR, Paidas C, Breneman J, Parham DM, Crist W; et al. (2004). "Age is an independent prognostic factor in rhabdomyosarcoma: a report from the Soft Tissue Sarcoma Committee of the Children's Oncology Group". Pediatr Blood Cancer. 42 (1): 64–73. doi:10.1002/pbc.10441. PMID 14752797.
- ↑ Dantonello TM, Int-Veen C, Winkler P, Leuschner I, Schuck A, Schmidt BF; et al. (2008). "Initial patient characteristics can predict pattern and risk of relapse in localized rhabdomyosarcoma". J Clin Oncol. 26 (3): 406–13. doi:10.1200/JCO.2007.12.2382. PMID 18202417.
- ↑ Meza JL, Anderson J, Pappo AS, Meyer WH, Children's Oncology Group (2006). "Analysis of prognostic factors in patients with nonmetastatic rhabdomyosarcoma treated on intergroup rhabdomyosarcoma studies III and IV: the Children's Oncology Group". J Clin Oncol. 24 (24): 3844–51. doi:10.1200/JCO.2005.05.3801. PMID 16921036.
- ↑ 19.0 19.1 Sultan I, Qaddoumi I, Yaser S, Rodriguez-Galindo C, Ferrari A (2009). "Comparing adult and pediatric rhabdomyosarcoma in the surveillance, epidemiology and end results program, 1973 to 2005: an analysis of 2,600 patients". J Clin Oncol. 27 (20): 3391–7. doi:10.1200/JCO.2008.19.7483. PMID 19398574.
- ↑ Little DJ, Ballo MT, Zagars GK, Pisters PW, Patel SR, El-Naggar AK; et al. (2002). "Adult rhabdomyosarcoma: outcome following multimodality treatment". Cancer. 95 (2): 377–88. doi:10.1002/cncr.10669. PMID 12124838.
- ↑ Bisogno G, Compostella A, Ferrari A, Pastore G, Cecchetto G, Garaventa A; et al. (2012). "Rhabdomyosarcoma in adolescents: a report from the AIEOP Soft Tissue Sarcoma Committee". Cancer. 118 (3): 821–7. doi:10.1002/cncr.26355. PMID 21751206.
- ↑ Donaldson SS, Anderson JR (2005). "Rhabdomyosarcoma: many similarities, a few philosophical differences". J Clin Oncol. 23 (12): 2586–7. doi:10.1200/JCO.2005.11.909. PMID 15728222.