Rhabdomyosarcoma staging: Difference between revisions

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{{Rhabdomyosarcoma}}
{{Rhabdomyosarcoma}}
{{CMG}}
{{CMG}};{{AE}} {{S.M}}
==Overview==
==Overview==
There are two [[Cancer staging|staging]] [[classification]] for [[rhabdomyosarcoma]] including Children group (CG) and [[tumor]], [[Node (physics)|node]], and [[metastasis]] system (TNM). Each of them has four stages of [[rhabdomyosarcoma]] based on the location of [[tumor]], size of [[tumor]], involvement of [[lymph nodes]], and [[metastasis]]. Also, [[Risk Stratification Tools|risk]] [[stratification]] [[system]] is used for [[classification]] of [[patients]] into low, intermediate, and high risk groups.
==Staging of rhabdomyosarcoma==
* There are two [[Cancer staging|staging]] [[classification]] for [[rhabdomyosarcoma]]:<ref name="pmid2407808">{{cite journal| author=Crist WM, Garnsey L, Beltangady MS, Gehan E, Ruymann F, Webber B et al.| title=Prognosis in children with rhabdomyosarcoma: a report of the intergroup rhabdomyosarcoma studies I and II. Intergroup Rhabdomyosarcoma Committee. | journal=J Clin Oncol | year= 1990 | volume= 8 | issue= 3 | pages= 443-52 | pmid=2407808 | doi=10.1200/JCO.1990.8.3.443 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=2407808  }} </ref>
** Clinical group (CG)
*** Created by intergroup rhabdomyosarcoma study group (IRSG) in 1972.
*** Based on spread of [[tumor]] [[Cells (biology)|cells]] at [[diagnosis]] and remaining [[disease]] after [[surgery]].
*** Categorized in four groups.
** [[Tumor]], node, and [[metastasis]] [[system]] (TNM)
*** Based on [[tumor]] size, node involvement, and [[metastases]].
***Categorized in four groups.
{| class="wikitable"
|+Clinical group staging<ref name="pmid7884423">{{cite journal| author=Crist W, Gehan EA, Ragab AH, Dickman PS, Donaldson SS, Fryer C et al.| title=The Third Intergroup Rhabdomyosarcoma Study. | journal=J Clin Oncol | year= 1995 | volume= 13 | issue= 3 | pages= 610-30 | pmid=7884423 | doi=10.1200/JCO.1995.13.3.610 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=7884423  }} </ref>
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Group
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Description
|-
| style="background:#DCDCDC;" align="center" + |I
| style="background:#F5F5F5;" + |
* Contain 13% of all cases
* Localized region
* Complete [[resection]]
* No nodal involvement
|-
| style="background:#DCDCDC;" align="center" + |II
| style="background:#F5F5F5;" + |
* Contain 20% of all cases
* IIA group: Complete [[resection]] with [[microscopic]] [[residual]] [[disease]]/ no nodal involvement
* IIB group: Complete [[resection]] with no [[microscopic]] [[residual]] [[Disease|diseases]]/ regional nodal involvement
* IIC group: Complete [[resection]] with [[microscopic]] [[residual]] [[disease]]/ regional nodal involvement
|-
| style="background:#DCDCDC;" align="center" + |III
| style="background:#F5F5F5;" + |
* Contain 48% of all cases
* Incomplete [[resection]] or [[biopsy]]
* [[Gross]] [[residual]] [[disease]]
|-
| style="background:#DCDCDC;" align="center" + |IV
| style="background:#F5F5F5;" + |
* Contain 18% of all cases
* Distant [[metastases]] at time of [[diagnosis]]
|}
{| class="wikitable"
|+TNM system<ref name="pmid11408506">{{cite journal| author=Crist WM, Anderson JR, Meza JL, Fryer C, Raney RB, Ruymann FB et al.| title=Intergroup rhabdomyosarcoma study-IV: results for patients with nonmetastatic disease. | journal=J Clin Oncol | year= 2001 | volume= 19 | issue= 12 | pages= 3091-102 | pmid=11408506 | doi=10.1200/JCO.2001.19.12.3091 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11408506  }}</ref><ref name="pmid27955730">{{cite journal| author=Dasgupta R, Fuchs J, Rodeberg D| title=Rhabdomyosarcoma. | journal=Semin Pediatr Surg | year= 2016 | volume= 25 | issue= 5 | pages= 276-283 | pmid=27955730 | doi=10.1053/j.sempedsurg.2016.09.011 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=27955730  }} </ref>
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Stage
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Description
|-
| style="background:#DCDCDC;" align="center" + |1
| style="background:#F5F5F5;" + |
* Involvement of [[orbit]], [[head]] and [[neck]] (except parameningeal), [[genitourinary]] (non-[[bladder]], non-[[prostate]]), and [[biliary tract]].
* [[Tumor]] stage [[invasion]]: T1 ( Confined to [[anatomic]] site of origin) or T2 ( include [[extension]]).
* [[Tumor]] size: a ( ≤5 cm in [[diameter]]) or b ( >5 cm in [[diameter]]).
* Regional nodes: It varies from N0 ( not clinically involve), N1 (clinically involved) to Nx (clinical status unknown).
* [[Metastases]]: M0 (no [[metastases]]).
|-
| style="background:#DCDCDC;" align="center" + |2
| style="background:#F5F5F5;" + |
* Involvement of [[Bladder]], [[prostate]], [[extremities]], [[cranial]] parameningeal, and other sites ( [[trunk]], [[retroperitoneum]], etc, excluding [[biliary tract]]).
* [[Tumor]] stage [[invasion]]: T1 ( Confined to [[anatomic]] site of [[origin]]) or T2 ( include [[extension]]).
* [[Tumor]] size: a ( ≤5 cm in [[diameter]]).
* Regional nodes: N0  (not clinically involve) N1 (clinically involved).
* [[Metastases]]: M0 (no [[metastases]]).
|-
| style="background:#DCDCDC;" align="center" + |3
| style="background:#F5F5F5;" + |
* Involvement of [[bladder]], [[prostate]], [[extremities]], [[cranial]] parameningeal, and other sites ( [[trunk]], [[retroperitoneum]], etc, excluding [[biliary tract]]).
* Tumor stage [[invasion]]: T1 ( Confined to [[anatomic]] site of origin) or T2 ( include [[extension]]).
* [[Tumor]] size: a ( ≤5 cm in [[diameter]]) or b ( >5 cm in [[diameter]]).
* Regional nodes: When [[tumor]] size is a, regional node category would be N1 ( clinically involve); however, if the [[tumor]] size is b, regional node category  varies from N0 ( not clinically involve), N1 (clinically involved) to Nx (clinical status unknown).
* [[Metastases]]: M0 (no [[metastases]]).
|-
| style="background:#DCDCDC;" align="center" + |4
| style="background:#F5F5F5;" + |
* Involvement could be all sites.
* [[Tumor]] stage: T1 ( Confined to [[anatomic]] site of [[origin]]) or T2 ( include [[extension]]).
* [[Tumor]] size: a ( ≤5 cm in [[diameter]]) or b ( >5 cm in [[diameter]]).
* Regional nodes: N0  (not clinically involve) N1 (clinically involved).
* [[Metastases]]: Present distant [[metastases]].
|}
{| class="wikitable"
|+Risk classification<ref name="pmid11846299">{{cite journal| author=Raney RB, Anderson JR, Barr FG, Donaldson SS, Pappo AS, Qualman SJ et al.| title=Rhabdomyosarcoma and undifferentiated sarcoma in the first two decades of life: a selective review of intergroup rhabdomyosarcoma study group experience and rationale for Intergroup Rhabdomyosarcoma Study V. | journal=J Pediatr Hematol Oncol | year= 2001 | volume= 23 | issue= 4 | pages= 215-20 | pmid=11846299 | doi= | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=11846299  }}</ref>
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Risk type
! style="background:#4479BA; color: #FFFFFF;" align="center" + |Description
|-
| style="background:#DCDCDC;" align="center" + |Low
| style="background:#F5F5F5;" + |
* [[Patients]] with [[embryonal rhabdomyosarcoma]] at a favorable sites ( stage 1).
* [[Patients]] with [[embryonal rhabdomyosarcoma]] at  an unfavorable sites with complete [[resection]] ( group I).
* [[Patients]] with [[embryonal rhabdomyosarcoma]] at an unfavorable site with [[microscopic]] [[residual]] [[disease]] (group II).
|-
| style="background:#DCDCDC;" align="center" + |Intermediate
| style="background:#F5F5F5;" + |
* [[Patients]] with [[embryonal rhabdomyosarcoma]] at an unfavorable site with [[gross]] [[residual]] [[disease]] (group III).
* [[Patients]] with [[metastatic]] [[embryonal rhabdomyosarcoma]] and [[age]] < 10 years.
* [[Patients]] with nonmetastatic [[alveolar rhabdomyosarcoma]].
|-
| style="background:#DCDCDC;" align="center" + |High
| style="background:#F5F5F5;" + |
* [[Patient]] with [[metastatic]] [[disease]] (excluding [[patients]] with [[metastatic]] [[embryonal rhabdomyosarcoma]] and [[age]] < 10 years).
|}


==References==
==References==
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Latest revision as of 15:36, 8 March 2019

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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

There are two staging classification for rhabdomyosarcoma including Children group (CG) and tumor, node, and metastasis system (TNM). Each of them has four stages of rhabdomyosarcoma based on the location of tumor, size of tumor, involvement of lymph nodes, and metastasis. Also, risk stratification system is used for classification of patients into low, intermediate, and high risk groups.

Staging of rhabdomyosarcoma

Clinical group staging[2]
Group Description
I
  • Contain 13% of all cases
  • Localized region
  • Complete resection
  • No nodal involvement
II
III
IV
TNM system[3][4]
Stage Description
1
2
3
4
Risk classification[5]
Risk type Description
Low
Intermediate
High

References

  1. ↑ Crist WM, Garnsey L, Beltangady MS, Gehan E, Ruymann F, Webber B; et al. (1990). "Prognosis in children with rhabdomyosarcoma: a report of the intergroup rhabdomyosarcoma studies I and II. Intergroup Rhabdomyosarcoma Committee". J Clin Oncol. 8 (3): 443–52. doi:10.1200/JCO.1990.8.3.443. PMID 2407808.
  2. ↑ Crist W, Gehan EA, Ragab AH, Dickman PS, Donaldson SS, Fryer C; et al. (1995). "The Third Intergroup Rhabdomyosarcoma Study". J Clin Oncol. 13 (3): 610–30. doi:10.1200/JCO.1995.13.3.610. PMID 7884423.
  3. ↑ Crist WM, Anderson JR, Meza JL, Fryer C, Raney RB, Ruymann FB; et al. (2001). "Intergroup rhabdomyosarcoma study-IV: results for patients with nonmetastatic disease". J Clin Oncol. 19 (12): 3091–102. doi:10.1200/JCO.2001.19.12.3091. PMID 11408506.
  4. ↑ Dasgupta R, Fuchs J, Rodeberg D (2016). "Rhabdomyosarcoma". Semin Pediatr Surg. 25 (5): 276–283. doi:10.1053/j.sempedsurg.2016.09.011. PMID 27955730.
  5. ↑ Raney RB, Anderson JR, Barr FG, Donaldson SS, Pappo AS, Qualman SJ; et al. (2001). "Rhabdomyosarcoma and undifferentiated sarcoma in the first two decades of life: a selective review of intergroup rhabdomyosarcoma study group experience and rationale for Intergroup Rhabdomyosarcoma Study V." J Pediatr Hematol Oncol. 23 (4): 215–20. PMID 11846299.

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