Patterns of failure for rhabdomyosarcoma of the perineal and perianal region
| Autor: | Michael P. LaQuaglia, Dana L. Casey, Paul A. Meyers, Leonard H. Wexler, Suzanne L. Wolden |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Adult
Male Cancer Research medicine.medical_specialty Adolescent medicine.medical_treatment Inguinal Canal Disease Perineum Ilium Young Adult Rare Diseases Medicine Humans Radiology Nuclear Medicine and imaging Cumulative incidence Rhabdomyosarcoma Embryonal Treatment Failure Rhabdomyosarcoma Child Lymph node Rhabdomyosarcoma Alveolar Radiation Lymphatic Irradiation business.industry Age Factors Cancer Infant Histology medicine.disease Prognosis Survival Analysis Surgery Tumor Burden Radiation therapy medicine.anatomical_structure Oncology Child Preschool Lymphatic Metastasis Disease Progression Female Lymph Lymph Nodes business |
| Zdroj: | International journal of radiation oncology, biology, physics. 89(1) |
| ISSN: | 1879-355X |
| Popis: | To analyze prognostic factors and patterns of failure for rhabdomyosarcoma of the perineal and perianal region (PRMS), with an emphasis on radiation therapy for locoregional control.Detailed records of all 14 patients treated for PRMS at Memorial Sloan-Kettering Cancer Center between 1998 and 2012 were reviewed. The Kaplan-Meier method was used to assess the event-free survival (EFS) and overall survival (OS), and a competing-risks analysis was used to assess the cumulative incidence of local, regional, and distant failures.Median age was 15.8 years (range, 1.1-31.9 years). High-risk features were identified: 9 of 14 patients (64%) had group 3 disease and 3 of 14 (21%) had group 4; 11 of 14 tumors (78%) were alveolar; 12 of 14 tumors (86%) were ≥5 cm; and 9 of 14 patients (64%) had involved lymph nodes (N1). Of those aged ≥10 years at diagnosis, 9 of 10 (90%) had alveolar histology, all had tumors ≥5 cm, and 8 of 10 (80%) presented with N1 disease. The rates of local, regional, and distant failure at 5 years were 17%, 31%, and 52%, respectively. Although 3 of the 4 patients with regional failure received nodal irradiation, only one of the nodal failures occurred in the radiation therapy field. The 5-year EFS was 33%, and OS was 39%. Age ≥10 years was associated with poor outcomes: EFS was 13% in patients aged ≥10 years, compared with 75% in those aged10 years (P=.04); the OS was 13% in patients aged ≥10 years, compared with 100% in those aged10 years (P=.04).Patients with PRMS, especially those aged ≥10 years, present with poor prognostic features and continue to have poor outcomes. Given the high incidence of regional node recurrence, we recommend prophylactic ilioinguinal lymph node irradiation for all patients aged ≥10 years. For children aged10 years, nodal evaluation is essential to determine the role for lymph node irradiation. |
| Databáze: | OpenAIRE |
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