title: Comparison of the prognostic value of assessing tumor diameter versus tumor volume at diagnosis or in response to initial chemotherapy in rhabdomyosarcoma.
abstract: OBJECTIVE
  In this study on a series of 205 patients with rhabdomyosarcoma, we investigated whether the prognostic effect of tumor size, at diagnosis or in terms of tumor response after induction chemotherapy, differed when tumor diameter or tumor volume were considered.
  
  
  METHODS
  Tumor size was assessed radiologically at diagnosis and, for the 108 patients with measurable disease, after three courses of chemotherapy. The analysis was based on multivariable models (linear for association between size and patient/tumor characteristics, Cox for association with survival). The predictive performance of the Cox model (estimated by V measure) was compared for the tumor's diameter and volume.
  
  
  RESULTS
  Initial tumor size was significantly larger in male or older patients and in T2 or alveolar tumors, but was not associated with the achievement of complete surgical resection. Initial tumor size significantly influenced overall survival. The risk of death was comparable for tumors 10 cm in maximum diameter and 194.0 cm(3) in volume. The predictive performance of the Cox model was much the same when the tumor's diameter or volume was considered. Tumor response was a significant predictor of survival, again irrespective of the type of tumor measurement considered.
  
  
  CONCLUSIONS
  In our analysis, initial tumor size and tumor response were significant prognostic factors in rhabdomyosarcoma, regardless of whether tumor diameter or volume was considered. Three-dimensional tumor assessment was of no greater prognostic value than one-dimensional assessment, neither initially nor after induction treatment.
authors.affiliation: Pediatric Oncology Unit, Division of Medical Statistics and Biometry, Radiology and Radiotherapy Department, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan, Italy. andrea.ferrari@istitutotumori.mi.it
authors.forename: Andrea
authors.initials: A
authors.lastname: Ferrari
authors.forename: Rosalba
authors.initials: R
authors.lastname: Miceli
authors.forename: Cristina
authors.initials: C
authors.lastname: Meazza
authors.forename: Michela
authors.initials: M
authors.lastname: Casanova
authors.forename: Francesca
authors.initials: F
authors.lastname: Favini
authors.forename: Carlo
authors.initials: C
authors.lastname: Morosi
authors.forename: Giovanna
authors.initials: G
authors.lastname: Trecate
authors.forename: Alfonso
authors.initials: A
authors.lastname: Marchianò
authors.forename: Roberto
authors.initials: R
authors.lastname: Luksch
authors.forename: Graziella
authors.initials: G
authors.lastname: Cefalo
authors.forename: Monica
authors.initials: M
authors.lastname: Terenziani
authors.forename: Filippo
authors.initials: F
authors.lastname: Spreafico
authors.forename: Daniela
authors.initials: D
authors.lastname: Polastri
authors.forename: Marta
authors.initials: M
authors.lastname: Podda
authors.forename: Serena
authors.initials: S
authors.lastname: Catania
authors.forename: Elisabetta
authors.initials: E
authors.lastname: Schiavello
authors.forename: Patrizia
authors.initials: P
authors.lastname: Giannatempo
authors.forename: Lorenza
authors.initials: L
authors.lastname: Gandola
authors.forename: Maura
authors.initials: M
authors.lastname: Massimino
authors.forename: Luigi
authors.initials: L
authors.lastname: Mariani
mesh_terms: D000293:Adolescent; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000494:pharmacology; D002648:Child; D002675:Child, Preschool; D003661:Decision Support Techniques; D005260:Female; D006801:Humans; D021621:Imaging, Three-Dimensional; D007558:Italy; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D011379:Prognosis; D016016:Proportional Hazards Models; D012208:Rhabdomyosarcoma / Q000188:drug therapy / Q000473:pathology*; D016019:Survival Analysis; D014057:Tomography, X-Ray Computed / Q000379:methods