Department of Radiation and Medical Oncology, Hubei Key Laboratory of Tumour Biological Behaviors, Hubei Cancer Clinical Study Center, Zhongnan Hospital of Wuhan University, Wuhan, China.
Department of Medical Record Management, Beijing South Medical District, Chinese PLA General Hospital, Beijing, China.
Clin Transl Oncol. 2023 Jun;25(6):1779-1792. doi: 10.1007/s12094-023-03076-x. Epub 2023 Jan 14.
Head and neck rhabdomyosarcoma (HNRMS) is a rare but aggressive malignant neoplasm. Given the young patient age and critical anatomy of the head and neck, performing surgery on the primary tumor still remains debatable. This study aimed to evaluate the impact of the non-surgery-based treatment versus surgery-based treatment on patients with nonmetastatic HNRMS.
Patients diagnosed with nonmetastatic HNRMS between 2004 and 2015 from the Surveillance, Epidemiology, and End Results (SEER) database were enrolled in our study. Inverse probability treatment weighting (IPTW) method was employed to balance confounding factors between surgery and non-surgery groups. Kaplan-Meier methods and COX regression analyses were used to analyze survival outcomes of overall survival (OS) and cancer-specific survival (CSS). Prognostic nomogram was established to predict survival.
A total of 260 eligible patients were extracted from the SEER database. Kaplan-Meier survival curves revealed that there was no significant difference in OS and CSS between the surgery and non-surgery groups both before and after IPTW (p > 0.05). Cox regression analyses and IPTW-adjusted Cox regression analyses for both OS and CSS showed similar survival between the two groups. Prognostic factors were explored and a nomogram for patients in the surgery group was constructed. Risk stratification based on the nomogram indicated that patients in surgery-high-risk group did not benefit from primary surgery. While those in surgery-low-risk group had an equal survival outcome to those in non-surgery group.
Our study revealed that compared to patients receiving surgery, those not receiving surgery had similar survival outcomes for nonmetastatic HNRMS. Our established nomogram may serve as a practical tool for individual prognostic evaluations.
头颈部横纹肌肉瘤（HNRMS）是一种罕见但具有侵袭性的恶性肿瘤。鉴于患者年龄较小且头颈部解剖结构关键，对原发性肿瘤进行手术仍然存在争议。本研究旨在评估非手术治疗与手术治疗对非转移性 HNRMS 患者的影响。
本研究纳入了 2004 年至 2015 年期间来自监测、流行病学和最终结果（SEER）数据库的诊断为非转移性 HNRMS 的患者。采用逆概率治疗加权（IPTW）方法平衡手术组和非手术组之间的混杂因素。Kaplan-Meier 方法和 COX 回归分析用于分析总生存率（OS）和癌症特异性生存率（CSS）的生存结果。建立预后列线图以预测生存。
从 SEER 数据库中提取了 260 名符合条件的患者。Kaplan-Meier 生存曲线显示，在 IPTW 前后，手术组和非手术组的 OS 和 CSS 均无显著差异（p>0.05）。COX 回归分析和 IPTW 调整的 COX 回归分析对于 OS 和 CSS 均显示两组之间的生存相似。探讨了预后因素，并为手术组患者构建了列线图。基于列线图进行风险分层表明，手术高风险组的患者并未从原发性手术中获益。而手术低风险组的患者与非手术组的生存结局相当。
与接受手术的患者相比，本研究显示未接受手术的非转移性 HNRMS 患者具有相似的生存结果。我们建立的列线图可能成为个体预后评估的实用工具。
