title: Rhabdomyosarcoma of the extremities: a focus on tumors arising in the hand and foot.
abstract: BACKGROUND
  Extremities are peculiar sites of origin for rhabdomyosarcomas (RMS) and are usually associated with an unfavorable outcome.
  
  
  METHODS
  The authors reviewed the clinical data on 60 patients <21 years old with limb RMS treated at the Pediatric Oncology Unit of the Istituto Nazionale Tumori of Milan, in Italy, over a 30-year period. Twelve patients had tumors arising in the hand and foot.
  
  
  RESULTS
  Complete tumor resection was achieved in 21 patients (but in only 1 case of hand/foot RMS); all patients received chemotherapy and 43 also had radiotherapy. The alveolar subtype was identified in 62% of cases. Half of the hand/foot cases had metastatic disease at onset. Overall survival at 5 years was 33% among the hand/foot cases and 56% for the others. Most of the relapsing cases had distant metastases.
  
  
  CONCLUSIONS
  A particularly poor survival was observed for RMS of the hand/foot due its marked tendency to spread. Surgical resection is particularly difficult in such cases and a multimodality treatment approach seems crucial to improving their outcome.
authors: Pediatric Oncology Unit, Fondazione IRCCS Istituto Nazionale Tumori, Milano, Italy.
authors: Michela
authors: M
authors: Casanova
authors: Cristina
authors: C
authors: Meazza
authors: Francesca
authors: F
authors: Favini
authors: Marco
authors: M
authors: Fiore
authors: Carlo
authors: C
authors: Morosi
authors: Andrea
authors: A
authors: Ferrari
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D005528:Foot / Q000473:pathology*; D006225:Hand / Q000473:pathology*; D006801:Humans; D007223:Infant; D007558:Italy; D008297:Male; D009362:Neoplasm Metastasis; D011879:Radiotherapy Dosage; D018714:Radiotherapy, Adjuvant; D012208:Rhabdomyosarcoma / Q000188:drug therapy / Q000401:mortality* / Q000532:radiotherapy / Q000628:therapy*; D055815:Young Adult