Fei-Zhang David J, Park Asher C, Berry Joseph M, Arch Rebecca S, Chelius Daniel C, Sheyn Anthony M, Rastatter Jeffrey C
Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL, 60611, USA.
Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL, 60611, USA.
Int J Pediatr Otorhinolaryngol. 2023 Jan;164:111419. doi: 10.1016/j.ijporl.2022.111419. Epub 2022 Dec 12.
Assessing the prognostic utility of lymph node status in pediatric rhabdomyosarcoma (RMS) patients and identifying demographic and clinical predictors of positive lymph node status among pediatric rhabdomyosarcoma patients.
Retrospective cohort study of head and neck RMS in patients with and without positive lymph node metastasis.
National Cancer Database (NCDB) was queried for patients of young (0-11 years) and adolescent (12-21 years) ages with head and neck RMS and confirmed positive or negative lymph node metastasis status. Descriptive analyses, Kaplan-Meier survival analyses, and multivariate logistic regressions were performed on extracted demographic and clinical characteristics.
Among 272 head and neck RMS patients, 146 (54%) were found to have positive lymph node metastasis. Alveolar RMS (n = 147, 54%) followed by embryonal RMS (n = 74, 27%) were the most represented histology types. Positive lymph node metastasis conferred significantly decreased survivability (p < 0.001) with a median survival period of 36.42 months compared to negative lymph node metastasis with a period of 53.47 months. Older age showed markedly increased odds (OR-2.02; 95%CI 1.22-3.38) of having lymph node metastasis when controlling for sex, race, insurance status, and Charlson-Comorbidity score. Alveolar histologies showed markedly increased odds of having lymph node metastasis (OR-3.21; 95%CI 1.96-5.31); embryonal histologies showed markedly decreased odds of having lymph node metastasis (OR-0.32; 95%CI 0.18-0.56) CONCLUSIONS: This study highlights the significant prognostic value of lymph node status among pediatric head and neck rhabdomyosarcoma patients while showcasing crucial demographic and pathological predictors of lymph node metastasis in said patients. Use of lymph node status in pediatric head and neck rhabdomyosarcoma will present future steps towards improving its clinical course.
评估淋巴结状态在小儿横纹肌肉瘤（RMS）患者中的预后效用，并确定小儿横纹肌肉瘤患者淋巴结阳性状态的人口统计学和临床预测因素。
对有和无淋巴结转移阳性的头颈部RMS患者进行回顾性队列研究。
查询国家癌症数据库（NCDB），以获取年龄在0至11岁的儿童和12至21岁的青少年头颈部RMS患者，并确认其淋巴结转移状态为阳性或阴性。对提取的人口统计学和临床特征进行描述性分析、Kaplan-Meier生存分析和多变量逻辑回归分析。
在272名头颈部RMS患者中，146名（54%）被发现有淋巴结转移阳性。最常见的组织学类型是肺泡型RMS（n = 147，54%），其次是胚胎型RMS（n = 74，27%）。与淋巴结转移阴性（中位生存期为53.47个月）相比，淋巴结转移阳性使生存率显著降低（p < 0.001），中位生存期为36.42个月。在控制性别、种族、保险状况和Charlson合并症评分后，年龄较大者发生淋巴结转移的几率显著增加（OR = 2.02；95%CI 1.22 - 3.38）。肺泡型组织学类型发生淋巴结转移的几率显著增加（OR = 3.21；95%CI 1.96 - 5.31）；胚胎型组织学类型发生淋巴结转移的几率显著降低（OR = 0.32；95%CI 0.18 - 0.56）。结论：本研究强调了淋巴结状态在小儿头颈部横纹肌肉瘤患者中的重要预后价值，同时展示了上述患者淋巴结转移的关键人口统计学和病理预测因素。在小儿头颈部横纹肌肉瘤中使用淋巴结状态将为改善其临床病程提供未来的方向。
