title: Adult rhabdomyosarcoma survival improved with treatment on multimodality protocols.
abstract: OBJECTIVE
  Rhabdomyosarcoma (RMS) is a pediatric sarcoma rarely occurring in adults. For unknown reasons, adults with RMS have worse outcomes than do children.
  
  
  METHODS
  We analyzed data from all patients who presented to Memorial Sloan-Kettering Cancer Center between 1990 and 2011 with RMS diagnosed at age 16 or older. One hundred forty-eight patients met the study criteria. Ten were excluded for lack of adequate data.
  
  
  RESULTS
  The median age was 28 years. The histologic diagnoses were as follows: embryonal 54%, alveolar 33%, pleomorphic 12%, and not otherwise specified 2%. The tumor site was unfavorable in 67% of patients. Thirty-three patients (24%) were at low risk, 61 (44%) at intermediate risk, and 44 (32%) at high risk. Forty-six percent were treated on or according to a prospective RMS protocol. The 5-year rate of overall survival (OS) was 45% for patients with nonmetastatic disease. The failure rates at 5 years for patients with nonmetastatic disease were 34% for local failure and 42% for distant failure. Among patients with nonmetastatic disease (n=94), significant factors associated with OS were histologic diagnosis, site, risk group, age, and protocol treatment. On multivariate analysis, risk group and protocol treatment were significant after adjustment for age. The 5-year OS was 54% for protocol patients versus 36% for nonprotocol patients.
  
  
  CONCLUSIONS
  Survival in adult patients with nonmetastatic disease was significantly improved for those treated on RMS protocols, most of which are now open to adults.
authors: Department of Radiation Oncology, Memorial Sloan-Kettering Cancer Center, New York, New York 10065, USA.
authors: Naamit Kurshan
authors: NK
authors: Gerber
authors: Leonard H
authors: LH
authors: Wexler
authors: Samuel
authors: S
authors: Singer
authors: Kaled M
authors: KM
authors: Alektiar
authors: Mary Louise
authors: ML
authors: Keohan
authors: Weiji
authors: W
authors: Shi
authors: Zhigang
authors: Z
authors: Zhang
authors: Suzanne
authors: S
authors: Wolden
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000704:Analysis of Variance; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000453:epidemiology / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D018232:Rhabdomyosarcoma, Alveolar / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D018233:Rhabdomyosarcoma, Embryonal / Q000453:epidemiology / Q000401:mortality / Q000473:pathology; D015996:Survival Rate; D017211:Treatment Failure; D055815:Young Adult