Abstract
BACKGROUND
The goal of the current study was to clarify treatment outcomes for adult patients with rhabdomyosarcoma (RMS). Published series have reported definitively worse results for adults with RMS compared with children with RMS. This finding casts doubt on whether RMS is the same disease in adults as it is in children.
METHODS
Of 190 patients with RMS who were age 18 years or older and whose cases were recorded over a 25βyear span in the pathology database of the Istituto Nazionale Tumori (Milan, Italy), 171 could be analyzed retrospectively for treatment outcome. The authors attempted to stratify patients according to the degree to which they had been treated appropriately, based on current treatment guidelines for childhood RMS.
RESULTS
The overall rate of response to chemotherapy was 85%. For the entire series, 5βyear eventβfree survival and 5βyear overall survival (OS) were 28% and 40%, respectively. Among the 110 patients with embryonal, alveolar, or βnot otherwise specifiedβ RMS, 5βyear OS was 46%; however, 5βyear OS was 61% for patients within this group (39% of the total) who had high scores for appropriate treatment.
CONCLUSIONS
The current series parallels other published series in that it confirms the finding of a relatively poor longβterm outcome for adult patients with RMS. However, for patients whose treatment adhered to the current guidelines for treatment of children, outcome was similar to what has been reported in pediatric series. In addition, the rate of response to chemotherapy for the entire series was similar to the rate typically observed among children. These findings suggest that adults and children with RMS should receive similar treatment. Treatment protocols adopted from pediatric programs but tailored to adults could increase adults' chances of receiving appropriate treatment; prospective studies are needed to test this idea. Cancer 2003;98:571β80. Β© 2003 American Cancer Society.
DOI 10.1002/cncr.11550