Rhabdomyosarcoma in adults. A retrospective analysis of 171 patients treated at a single institution.
BACKGROUND
The goal of the current study was to clarify treatment outcomes for adult patients with rhabdomyosarcoma (RMS). Published series have reported definitively worse results for adults with RMS compared with children with RMS. This finding casts doubt on whether RMS is the same disease in adults as it is in children.


METHODS
Of 190 patients with RMS who were age 18 years or older and whose cases were recorded over a 25-year span in the pathology database of the Istituto Nazionale Tumori (Milan, Italy), 171 could be analyzed retrospectively for treatment outcome. The authors attempted to stratify patients according to the degree to which they had been treated appropriately, based on current treatment guidelines for childhood RMS.


RESULTS
The overall rate of response to chemotherapy was 85%. For the entire series, 5-year event-free survival and 5-year overall survival (OS) were 28% and 40%, respectively. Among the 110 patients with embryonal, alveolar, or 'not otherwise specified' RMS, 5-year OS was 46%; however, 5-year OS was 61% for patients within this group (39% of the total) who had high scores for appropriate treatment.


CONCLUSIONS
The current series parallels other published series in that it confirms the finding of a relatively poor long-term outcome for adult patients with RMS. However, for patients whose treatment adhered to the current guidelines for treatment of children, outcome was similar to what has been reported in pediatric series. In addition, the rate of response to chemotherapy for the entire series was similar to the rate typically observed among children. These findings suggest that adults and children with RMS should receive similar treatment. Treatment protocols adopted from pediatric programs but tailored to adults could increase adults' chances of receiving appropriate treatment; prospective studies are needed to test this idea.
Ferrari
Andrea
A
Pediatric Oncology Unit, Istituto Nazionale Tumori, Milan, Italy. andrea.ferrari@istitutotumori.mi.it
Dileo
Palma
P
Casanova
Michela
M
Bertulli
Rossella
R
Meazza
Cristina
C
Gandola
Lorenza
L
Navarria
Pierina
P
Collini
Paola
P
Gronchi
Alessandro
A
Olmi
Patrizia
P
Fossati-Bellani
Franca
F
Casali
Paolo G
PG
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D011879:Radiotherapy Dosage; D012189:Retrospective Studies; D018232:Rhabdomyosarcoma, Alveolar / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D018233:Rhabdomyosarcoma, Embryonal / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000401:mortality / Q000628:therapy; D015996:Survival Rate; D016896:Treatment Outcome