Prognostic role of pleural effusion or ascites in localized rhabdomyosarcoma

Autor: Antonio Ruggiero, Fraia Melchionda, Giuseppe Milano, Carla Manzitti, Andrea Ferrari, Giovanni Scarzello, Daniela Di Carlo, Ilaria Zanetti, Gianni Bisogno, Tiziana Toffolutti, Patrizia Dall'Igna
Rok vydání: 2018
Předmět:
Male
medicine.medical_specialty
Pleural effusion
Kaplan-Meier Estimate
03 medical and health sciences
0302 clinical medicine
pleural effusion
Ascites
Antineoplastic Combined Chemotherapy Protocols
Rhabdomyosarcoma
medicine
ascites
rhabdomyosarcoma
Humans
Multicenter Studies as Topic
In patient
Preschool
Child
Retrospective Studies
Malignant
Clinical Trials as Topic
business.industry
Soft tissue sarcoma
Disease Management
Infant
Hematology
medicine.disease
Prognosis
Combined Modality Therapy
Confidence interval
Hyperfractionated radiotherapy
Progression-Free Survival
Pleural Effusion
Malignant
Child
Preschool
Female
Italy
Organ Specificity
Treatment Outcome
Oncology
Effusion
Settore MED/38 - PEDIATRIA GENERALE E SPECIALISTICA
030220 oncology & carcinogenesis
Pediatrics
Perinatology and Child Health
Radiology
medicine.symptom
business
030215 immunology
Zdroj: Pediatric bloodcancerREFERENCES. 66(11)
ISSN: 1545-5017
Popis: Purpose The presence of pleural effusion or ascites at the time of diagnosis is generally considered a poor prognostic factor for children with rhabdomyosarcoma (RMS), and treatment is usually intensified despite the fact that there are no published studies to support this decision. We investigated the prognostic role of the presence of pleural effusion or ascites at diagnosis in patients with localized RMS consecutively enrolled in the Italian Soft Tissue Sarcoma Committee protocols over a 30-year period. Methods We reviewed the radiological reports at diagnosis of 150 children with supradiaphragmatic and infradiaphragmatic RMS, noting any presence of effusion and its extent (minimal, moderate, or massive). All patients received intensive chemotherapy, surgery, and standard or hyperfractionated radiotherapy. Results Effusion was identified in 32 children (21.3%), 14 with pleural effusion and 18 with ascites. As for its extent, 13 children presented with minimal, 12 with moderate, and 7 with massive effusion. The 5-year progression-free survival (PFS) rate was 49.8% (confidence interval [CI] 31.7-65.5) and 49.5% (CI 40-58.2) for patients with and without effusion, respectively (P = .5). When only patients with moderate or massive effusion were considered, however, their PFS was 36.8% (CI 16.5-57.5) versus 51.2% (CI 42.2-59.5) in patients with minimal or no effusion (P = .01). On the whole, patients with pleural effusion had a very poor outcome with a 5-year PFS of 35.7% (CI 13-59.4). Conclusions The presence of moderate or massive effusion seems to be an unfavorable prognostic factor in children with RMS, and justifies their inclusion in experimental studies.
Databáze: OpenAIRE
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