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. Rhabdomyosarcoma is associated with a 5 year survival rate of 72%. The presence of metastasis is associated with a particularly poor prognosis. Histologically, the embryonal type rhabdomyosarcoma and anatomically, the orbital and genitourinary tract rhabdomyosarcomas have the most favorable prognosis.
Complications
- Rhabdomyosarcoma may cause metastasis to other organs.[1]
- Patients may develop with some complications after treatment such as:[5]
- 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:[6]
- Presence of gross residual disease after initial surgery located in unfavorable sites
- lymphnodeinvolvement (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[7][8][9] |
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| Bladder and bowl problems [10][11] | Bladder:
Bowl:
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| Eye problems[12] |
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| Dental and facial problems[13][14] |
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Prognosis
- Rhabdomyosarcoma prognosis are considered as a favorable one in presence of following criteria:[15][16][17]
- No distant metastases at diagnosis
- Primary tumors sites:
- orbit tumors
- Nonparameningeal head and neck tumors
- Genitourinary tumors (non-bladder or prostate tumors)
- Complete surgical removal of the localized tumor at the time of diagnosis
- Embyonal rhabdomyosarcoma or botryoid on histology
- Tumor size ≤5 cm
- Patient's age between 1 to 10 years old
- Adults and adolescents have worse outcome rather than children.[18][19]
| 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.
- ↑ 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.
- ↑ 18.0 18.1 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.