Survival of head and neck rhabdomyosarcoma in children: a clinical analysis of 98 cases

Abstract

Objective To analysis the prognosis of head and neck rhabdomyosarcoma (RMS) in pediatrics. Methods The clinical data of 98 pediatric patients with head and neck RMS admitted from February 2005 to September 2017 were retrospectively analyzed. The clinical staging and risk grouping were performed according to international rhabdomyosarcoma study group criterion. The treatment included chemotherapy, radiotherapy and surgery accordingly. The association of prognosis with the disease characters, treatment strategy of 98 patients RMS was analyzed by Chi-square test and Kaplan-Merier analysis with SPSS 20.0 software. Results There were 53 boys (54.1%) and 45 girls (45.9%) with a median age of 70 months (2-161 months). There were 43 cases of orbit RMS (43.9%) , 46 cases of paramenigneal RMS (46.9%) and 9 cases of non-paramenigneal and non-orbit RMS (9.2%) . Twenty seven patients were classified as low risk (27.6%), 42 patients as medium risk (42.9%), and 29 patients as high risk (29.5%). The patients were followed up for a medium of 42 months (9-149 months), 37 cases were dead, 60 cases were survival, and 1 lost the follow-up. Kaplan-Merier survival analysis showed that the overall survival (OS) was 61.9% (60/97), and the average survival time was (92.3±6.9) months. Univariate analysis showed that the OS of patients with paramenigneal RMS was poorer than that of patients with orbit RMS, non-paramenigneal and non-orbit RMS. The OS of high risk RMS patients was poorer than that of intermediate and low risk patients (χ2=6.132, P=0.047) . Conclusions The prognosis of head and neck RMS in children is generally good, but the prognosis of paramenigneal RMS and high-risk RMS is significantly declined. The primary site of paramenigneal and high risk are independent risk factors for the prognosis of head and neck RMS in children. Key words: Rhabdomyosarcoma; Child; Head and neck neoplasms; Prognosis