Hematology Oncology Department Sylvester Comprehensive Cancer Center, University of Miami Miami, Florida ; Department of Sarcoma Medical Oncology MD Anderson Cancer Center, University of Texas Houston, Texas.
Cancer Med. 2013 Aug;2(4):553-63. doi: 10.1002/cam4.92. Epub 2013 Jul 15.
Adult rhabdomyosarcoma (RMS) is a rare tumor that has inferior outcome compared to younger patient population. The present work aims to study the age-related differences in management of adolescents and adults with RMS. Under an institutional review board-approved protocol, we retrospectively analyzed 239 patients, 10 years of age and greater, diagnosed with RMS at MD Anderson Cancer Center from 1957 through 2003. Of the 239 patients, 163 patients were nonmetastatic with a median overall survival (OS) of 3.8 years (95% CI 2.8-7.6). In the multivariate analysis, age >50 was significantly associated with shorter OS and recurrence-free survival (RFS) for primary patients. Metastases were present in 76 patients, the median OS was 1.4 years. Approximately 13% of metastatic patients <50 years old had a long-term survival exceeding 15 years. Multimodality therapy, including surgery, radiotherapy, and chemotherapy was significantly associated with longer OS in primary and metastatic patients. Use of bi- and triple modality treatment decreased in metastatic patients over 50 years of age compared to younger patients. RMS in adolescents and adults has a poor outcome compared with younger individuals. Increased use of multidisciplinary therapy may improve older patient clinical outcome.
成人横纹肌肉瘤（RMS）是一种罕见的肿瘤，与年轻患者群体相比，其预后较差。本研究旨在研究青少年和成人 RMS 管理中的年龄相关差异。根据机构审查委员会批准的方案，我们回顾性分析了 1957 年至 2003 年期间在 MD 安德森癌症中心诊断为 RMS 的 239 名年龄在 10 岁及以上的患者。在 239 名患者中，163 名患者为非转移性，中位总生存期（OS）为 3.8 年（95%CI 2.8-7.6）。在多变量分析中，年龄>50 岁与原发性患者的 OS 和无复发生存率（RFS）较短显著相关。76 名患者存在转移，中位 OS 为 1.4 年。<50 岁的转移性患者中，约有 13%的患者长期生存超过 15 年。包括手术、放疗和化疗在内的多模式治疗与原发性和转移性患者的 OS 延长显著相关。与年轻患者相比，50 岁以上的转移性患者中使用双模式和三模式治疗的比例下降。青少年和成人的 RMS 与年轻患者相比预后较差。增加多学科治疗的应用可能会改善老年患者的临床结局。
