Pediatric rhabdomyosarcoma of the head and neck.
OBJECTIVE
Survival for pediatric rhabdomyosarcoma has improved with the use of multidrug chemotherapy and external beam radiotherapy. This study was performed to determine survival in a cohort of patients treated on one of three multidrug treatment protocols for head and neck rhabdomyosarcoma and to identify factors that place patients at risk for treatment failure.


METHODS
Pertinent prognostic variables including age, sex, subsite of origin, resectability, and TNM stage were analyzed by the Kaplan-Meier methods with comparisons between variables performed using the Prentice-Wilcoxon test statistic.


RESULTS
Overall 5-year survival was 74% (95% confidence interval 64% to 84%). Local failure accounted for the cause of death in 10 patients, and 8 died of disseminated disease. On univariate analysis, each variable contributing to the TNM staging system was significant in determining survival; invasiveness (P = 0.01), size (P = 0.02), nodal metastases (P <0.01), and distant disease (P <0.01).


CONCLUSIONS
Survival has improved for head and neck rhabdomyosarcoma treated with multimodality therapy. Patients with advanced-stage disease are at greatest risk for treatment failure and require the most aggressive therapy.
Kraus
D H
DH
Department of Surgery, Memorial Sloan-Kettering Cancer Center, New York, New York 10021, USA.
Saenz
N C
NC
Gollamudi
S
S
Heller
G
G
Moustakis
M
M
Gardiner
S
S
Gerald
W L
WL
Ghavimi
F
F
LaQuaglia
M P
MP
D002648:Child; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006258:Head and Neck Neoplasms / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery; D006801:Humans; D008297:Male; D009367:Neoplasm Staging; D011379:Prognosis; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000188:drug therapy / Q000401:mortality* / Q000601:surgery; D012307:Risk Factors; D016019:Survival Analysis; D015996:Survival Rate; D013997:Time Factors; D017211:Treatment Failure