Treatment Outcome and Predictors of Survival in Thai Adult Rhabdomyosarcoma Cases

Abstract

Background: Adult rhabdomyosarcoma (RMS) is a rare and aggressive disease with limited data compared with pediatric RMS. The goal of this study was to determine the treatment outcome and identify factors related to survival outcome in Thailand. Materials and Methods: Adult patients (≥15 years old) with the pathological diagnosis of RMS between 1985 and 2010 were reviewed. The data were retrospectively reviewed from the pathological results and medical records from Srinagarind Hospital, Khon Kaen University. Results: A total of 34 patients were identified in the study. The median age at diagnosis was 35.5 years and the most common primary sites were extremity and the head and neck region. The incidence of pleomorphic RMS increased with age and none was found in those aged younger than 20 years old. The median survival time was 9.33 months (95%CI: 5.6-13.1). The 1-and 5-year survival rates were 38.2% (22.3-54.0) and 20.6% (9.1-35.3). On multivariate analysis, age and size of tumor did not predict better outcome while chemotherapy and surgery were significantly associated with longer survival. Conclusions: Outcome of adult RMS was poor. Surgery and chemotherapy are strongly associated with better prognosis and multimodality treatment should be incorporated in the clinic.

Call for improved design and reporting in soft tissue sarcoma studies: A systematic review and meta‐analysis of chemotherapy and survival outcomes in resectable STS

“…Some studies included children as young as three years of age. Four studies reported their population consisted of “adult patients” but included patients as young as 15 years of age . In one study that did stratify by age, their pediatric ( < 18 years) and adult ( > 15 years) populations overlapped .…”

“…Four studies reported their population consisted of "adult patients" but included patients as young as 15 years of age. [32][33][34][35] In one study that did stratify by age, their pediatric ( < 18 years) and adult ( > 15 years) populations overlapped. 35 Ultimately, the inclusion of patients aged 15 to 17 years in several well-designed, relevant cohort studies lamentably precluded them from being included in our analysis.…”

Diagnosis and treatment of rhabdomyosarcomas

“…The use of radiotherapy was also associated with better survival of the patients both in the local disease stage, as well as for disseminated disease [147,200,201]. Including chemotherapy was found to be an independent prognostic factor causing lower mortality due to the progress of the neoplastic disease according to the analysis of patients from a center in Thailand [202]. There are, however, also reports on the lack of improvement of survival of patients subjected to chemotherapy in comparison to a control group [201].…”