title: Rhabdomyosarcoma in children: a SEER population based study.
abstract: OBJECTIVE
  To examine incidence and outcomes for pediatric rhabdomyosarcoma (RMS).
  
  
  METHODS
  The SEER registry was examined for patients with RMS < 20 y old.
  
  
  RESULTS
  Overall, 1544 patients were identified for an incidence of 0.4414/100,000 per year. Males outnumbered females 3:2. Tumors were classified as embryonal (67%), alveolar (32%), and pleomorphic (1%). Alveolar and pleomorphic RMS were more common in adolescents, whereas embryonal type was more common in younger children (P = 0.0001). Pleomorphic (47%) and alveolar (39%) RMS commonly presented with distant disease, in contrast to embryonal (25%). Most patients had surgical resection (81%) and radiotherapy (63%). Overall, 5- and 10-y survival was 60% and 57%, respectively. Univariate analysis identified higher survival for age < 10 y, local stage, favorable site, embryonal type, <5 cm tumor size, and surgical resection. Multivariate analysis identified non-embryonal type (HR 1.451), non-favorable site (HR 1.570), no surgery (HR 1.726), age ≥ 10 y (HR 1.734), 1973-1978 diagnosis year (HR 1.730), and distant disease (HR 3.456) as independent predictors of mortality.
  
  
  CONCLUSIONS
  Embryonal histology, the most common type of pediatric RMS, presents in young children and has better prognosis than alveolar or pleomorphic types. Patients with embryonal tumors, favorable tumor location, age < 10 y, localized disease, and surgical resection have improved survival.
authors.affiliation: Division of Pediatric Surgery and Division of Surgical Oncology, DeWitt Daughtry Family Department of Surgery, University of Miami Miller School of Medicine, Miami, Florida, USA.
authors.forename: Eduardo A
authors.initials: EA
authors.lastname: Perez
authors.forename: Noor
authors.initials: N
authors.lastname: Kassira
authors.forename: Michael C
authors.initials: MC
authors.lastname: Cheung
authors.forename: Leonidas G
authors.initials: LG
authors.lastname: Koniaris
authors.forename: Holly L
authors.initials: HL
authors.lastname: Neville
authors.forename: Juan E
authors.initials: JE
authors.lastname: Sola
mesh_terms: D000293:Adolescent; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D015994:Incidence; D007223:Infant; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D011237:Predictive Value of Tests; D018232:Rhabdomyosarcoma, Alveolar / Q000401:mortality* / Q000601:surgery / Q000628:therapy; D018233:Rhabdomyosarcoma, Embryonal / Q000401:mortality* / Q000601:surgery / Q000628:therapy; D018426:SEER Program / Q000706:statistics & numerical data*; D017678:Sex Distribution; D012983:Soft Tissue Neoplasms / Q000401:mortality* / Q000601:surgery / Q000628:therapy; D055815:Young Adult