Department of Pediatrics, Stanford University, Stanford, California, USA.
Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, USA.
Pediatr Blood Cancer. 2022 Jun;69(6):e29644. doi: 10.1002/pbc.29644. Epub 2022 Mar 6.
The Children's Oncology Group (COG) uses Clinical Group (CG) and modified Tumor Node Metastasis (TNM) stage to classify rhabdomyosarcoma (RMS). CG is based on surgicopathologic findings and is determined after the completion of initial surgical procedure(s) but prior to chemotherapy and/or radiation therapy. The modified TNM stage is based on clinical and radiographic findings and is assigned prior to any treatment. These systems have evolved over several decades. We review the history, evolution, and rationale behind the current CG and modified TNM classification systems used by COG for RMS. Data from the seven most recently completed and reported frontline COG trials (D9602, D9802, D9803, ARST0331, ARST0431, ARST0531, ARST08P1) were analyzed, and confirm that CG and modified TNM stage remain relevant and useful for predicting prognosis in RMS. We propose updates based on recent data and discuss factors warranting future study to further optimize these classification systems.
儿童肿瘤学组（COG）使用临床分组（CG）和改良的肿瘤淋巴结转移（TNM）分期来分类横纹肌肉瘤（RMS）。CG 基于手术病理发现，在初始手术完成后但在化疗和/或放疗之前确定。改良的 TNM 分期基于临床和影像学发现，并在任何治疗之前分配。这些系统已经发展了几十年。我们回顾了 COG 目前用于 RMS 的 CG 和改良 TNM 分类系统的历史、演变和基本原理。对最近完成和报告的七个 COG 一线试验（D9602、D9802、D9803、ARST0331、ARST0431、ARST0531、ARST08P1）的数据进行了分析，证实 CG 和改良的 TNM 分期仍然与 RMS 的预后预测相关且有用。我们根据最近的数据提出了更新，并讨论了未来需要进一步研究的因素，以进一步优化这些分类系统。
