In:
Cancer Medicine, Wiley, Vol. 7, No. 8 ( 2018-08), p. 4023-4035
Abstract:
Five‐year overall survival ( OS ) of localized RMS exceeds 70% in children ( 〈 18) but is very poor in adult patients. We analyzed the outcome and prognostic factors ( PF ) of a national series of adult patients with RMS in a large study. The study population consisted of two different cohorts: a retrospective cohort (157 adult patients treated in 13 reference centers between 05/1981 and 02/2010) and the prospective cohort (292 patients with RMS diagnosed and treated between 01/2010 and 12/2014 in France) included in the NetSarc database. A descriptive analysis of patients’ characteristics and prognostic factors was conducted on both series which were compared. In the retrospective series, histological subtypes were embryonal (E‐ RMS ) for 21% of patients, alveolar (A‐ RMS ) for 35% of patients, and “adult‐type” P‐ RMS (pleomorphic, spindle cell RMS , not otherwise specified) (P) for 44% patients. This distribution significantly differed in the prospective cohort: A‐ RMS : 18%; E‐ RMS : 17%; and P‐ RMS 65%. With a median follow‐up of 8.5 years, 5‐year OS for localized RMS and advanced RMS (with nodes and/or metastases) was 43% and 5%, respectively, ( P 〈 0.0001), and median OS was 51, 33, and 16 months for E‐ RMS , A‐ RMS , and P‐ RMS , respectively, in the retrospective cohort. The median OS was less than 40 months for the prospective nationwide cohort for the entire population. In a multivariate analysis of the retrospective study, independent prognostic factors for OS were A‐ RMS , R0 resection, and adjuvant radiotherapy ( RT ). For localized RMS , age and use of pediatric chemotherapy ( CT ) regimen are independent prognostic factors. Adult patients with RMS have a poorer overall survival than pediatric patients, and survival varies considerably across histological subtypes.
Type of Medium:
Online Resource
ISSN:
2045-7634
,
2045-7634
DOI:
10.1002/cam4.2018.7.issue-8
Language:
English
Publisher:
Wiley
Publication Date:
2018
detail.hit.zdb_id:
2659751-2
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