Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, USA.
Pediatr Blood Cancer. 2024 Nov;71(11):e31303. doi: 10.1002/pbc.31303. Epub 2024 Sep 3.
To describe clinical features, risk factors, and outcomes of patients with perineal and perianal rhabdomyosarcoma.
The records of 51 patients (38 perineal and 13 perianal) enrolled on Children's Oncology Group clinical trials between 1997 and 2012 were reviewed.
At presentation, 53% were female, 65% were older than 10 years of age, 76% were alveolar histology, 76% were more than 5 cm, 84% were invasive, 65% were regional node positive by imaging, 49% were metastatic, only 16% were grossly resected upfront, and 25% of patients had a delayed excision. At a median follow-up of 6.13 years, estimated 5-year event-free survival (EFS) was 38% [22.17%-53.38%], and overall survival (OS) was 42% [26.66%-58.21%]. The rates of local, regional, and distant failure were 15.6%, 13.7%, 43.1%, respectively; all failures ultimately died. By univariate analysis, only age more than 10 years negatively impacted 5-year EFS (p = .023) and OS (p = .09), and IRS Group also impacted OS (p = .043). In Cox proportional hazards model, neither of these variables were significant after adjusting for other factors.
Patients with perineal and perianal rhabdomyosarcoma have a poor overall prognosis, probably related to poor patient and disease characteristics at presentation.
描述会阴和肛周横纹肌肉瘤患者的临床特征、风险因素和结局。
回顾了 1997 年至 2012 年期间参加儿童肿瘤学组临床试验的 51 名患者(38 名会阴和 13 名肛周)的记录。
就诊时,53%为女性,65%年龄大于 10 岁,76%为肺泡组织学,76%肿瘤大于 5cm,84%为侵袭性,65%影像学显示区域淋巴结阳性,49%为转移性,仅有 16%患者初始进行了大体完全切除,25%的患者存在延迟切除。中位随访 6.13 年后,估计 5 年无事件生存率(EFS)为 38%[22.17%-53.38%],总生存率(OS)为 42%[26.66%-58.21%]。局部、区域和远处失败的发生率分别为 15.6%、13.7%和 43.1%;所有失败的患者最终都死亡了。单因素分析显示,仅 10 岁以上年龄对 5 年 EFS(p=0.023)和 OS(p=0.09)有负面影响,IRS 分组也对 OS 有影响(p=0.043)。在 Cox 比例风险模型中,在调整其他因素后,这些变量均无统计学意义。
会阴和肛周横纹肌肉瘤患者的总体预后较差,这可能与患者和疾病的特征有关。