Rhabdomyosarcoma natural history, complications and prognosis: Difference between revisions

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** Secondary malignancies
** Secondary malignancies
*** Skin and bone tumors regarding radiotherapy
*** Skin and bone tumors regarding radiotherapy
* Recurrent rhabdomyosarcoma is prevalent among patients with following criteria:<ref name="pmid23418028">{{cite journal| author=Dantonello TM, Int-Veen C, Schuck A, Seitz G, Leuschner I, Nathrath M et al.| title=Survival following disease recurrence of primary localized alveolar rhabdomyosarcoma. | journal=Pediatr Blood Cancer | year= 2013 | volume= 60 | issue= 8 | pages= 1267-73 | pmid=23418028 | doi=10.1002/pbc.24488 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=23418028  }} </ref>
** Presence of gross residual disease after initial surgery located in unfavorable sites
** lymphnodeinvolvement (N1)
** Tumor size > 5cm
** Age< 10 years
** Alveolar rhabdomyosarcoma
** Distant metastatic at diagnosis
* Long-term complications after treatment regarding to different organs are listed below:
* Long-term complications after treatment regarding to different organs are listed below:
{| class="wikitable"
{| class="wikitable"

Revision as of 17:11, 20 February 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Shadan Mehraban, M.D.[2]

Overview

Common complications of rhabdomyosarcoma include metastasis to lung, bone marrow, and bone. Rhabdomyosarcoma is associated with a 5 year survival rate of 72%. The presence of metastasis is associated with a particularly poor prognosis. Histologically, the embryonal type rhabdomyosarcoma and anatomically, the orbital and genitourinary tract rhabdomyosarcomas have the most favorable prognosis.

Complications

  • Rhabdomyosarcoma may cause metastasis to other organs.[1]
    • Less than 25% of patients present with distant metastases at he time of diagnosis.[2]
    • The common metastatic site is lung.
    • The other metastatic sites are as following:[3][4]
      • Bone marrow (30%)
      • Bone (30%)
      • Omentum and ascites (16%)
      • Pleura (13%)
      • Visceral involvement
      • brain metastases
  • Patients may develop with some complications after treatment such as:[5]
    • Cardiomyopathy
      • Regarding anthracycline and cyclophosphamide use
    • Pulmonary failure
    • Renal electrolyte wasting
      • Regarding ifosfamide use
    • Acute myelogenous leukemia
      • Regarding etoposide use
    • Secondary malignancies
      • Skin and bone tumors regarding radiotherapy
  • Recurrent rhabdomyosarcoma is prevalent among patients with following criteria:[6]
    • Presence of gross residual disease after initial surgery located in unfavorable sites
    • lymphnodeinvolvement (N1)
    • Tumor size > 5cm
    • Age< 10 years
    • Alveolar rhabdomyosarcoma
    • Distant metastatic at diagnosis
  • Long-term complications after treatment regarding to different organs are listed below:
Affected organs Long-term complications
Head and neck problems[7][8][9]
  • Short stature ( due to growth hormone deficiency after radiotherapy to hypothalamic-pituitary area)
  • Facial asymmetry
  • Poor dentition
  • Impaired hearing, vision, and learning
Bladder and bowl problems [10][11] Bladder:
  • Incontinency,
  • Frequency
  • Nocturia

Bowl:

  • Hemorrhagic cystitis
  • Primary hypogonadism
Eye problems[12]
  • Cataract
  • Orbital hypoplasia
Dental and facial problems[13][14]
  • Bony hypoplasia
  • Tooth and root agenesis
  • Trismus
  • Microdontia
  • Enamel defects
  • Osteonecrosis

Prognosis

  • Rhabdomyosarcoma is associated with a 5 year survival rate of 72%.
  • The presence of metastasis is associated with a particularly poor prognosis among patients with rhabdomyosarcoma. The 5 year event free survival rate is less than 30%.
  • Histologically, the embryonal type rhabdomyosarcoma and anatomically, the orbital and genitourinary tract rhabdomyosarcomas have the most favorable prognosis.

References

  1. Raney RB, Tefft M, Maurer HM, Ragab AH, Hays DM, Soule EH; et al. (1988). "Disease patterns and survival rate in children with metastatic soft-tissue sarcoma. A report from the Intergroup Rhabdomyosarcoma Study (IRS)-I". Cancer. 62 (7): 1257–66. PMID 2843274.
  2. Koscielniak E, Rodary C, Flamant F, Carli M, Treuner J, Pinkerton CR; et al. (1992). "Metastatic rhabdomyosarcoma and histologically similar tumors in childhood: a retrospective European multi-center analysis". Med Pediatr Oncol. 20 (3): 209–14. PMID 1574030.
  3. Ruymann FB, Newton WA, Ragab AH, Donaldson MH, Foulkes M (1984). "Bone marrow metastases at diagnosis in children and adolescents with rhabdomyosarcoma. A report from the intergroup rhabdomyosarcoma study". Cancer. 53 (2): 368–73. PMID 6546301.
  4. Breneman JC, Lyden E, Pappo AS, Link MP, Anderson JR, Parham DM; et al. (2003). "Prognostic factors and clinical outcomes in children and adolescents with metastatic rhabdomyosarcoma--a report from the Intergroup Rhabdomyosarcoma Study IV". J Clin Oncol. 21 (1): 78–84. doi:10.1200/JCO.2003.06.129. PMID 12506174.
  5. Punyko JA, Mertens AC, Gurney JG, Yasui Y, Donaldson SS, Rodeberg DA; et al. (2005). "Long-term medical effects of childhood and adolescent rhabdomyosarcoma: a report from the childhood cancer survivor study". Pediatr Blood Cancer. 44 (7): 643–53. doi:10.1002/pbc.20310. PMID 15700252.
  6. Dantonello TM, Int-Veen C, Schuck A, Seitz G, Leuschner I, Nathrath M; et al. (2013). "Survival following disease recurrence of primary localized alveolar rhabdomyosarcoma". Pediatr Blood Cancer. 60 (8): 1267–73. doi:10.1002/pbc.24488. PMID 23418028.
  7. Raney RB, Asmar L, Vassilopoulou-Sellin R, Klein MJ, Donaldson SS, Green J; et al. (1999). "Late complications of therapy in 213 children with localized, nonorbital soft-tissue sarcoma of the head and neck: A descriptive report from the Intergroup Rhabdomyosarcoma Studies (IRS)-II and - III. IRS Group of the Children's Cancer Group and the Pediatric Oncology Group". Med Pediatr Oncol. 33 (4): 362–71. PMID 10491544.
  8. Katz JR, Bareille P, Levitt G, Stanhope R (2001). "Growth hormone and segmental growth in survivors of head and neck embryonal rhabdomyosarcoma". Arch Dis Child. 84 (5): 436–9. PMC 1718743. PMID 11316695.
  9. Paulino AC, Simon JH, Zhen W, Wen BC (2000). "Long-term effects in children treated with radiotherapy for head and neck rhabdomyosarcoma". Int J Radiat Oncol Biol Phys. 48 (5): 1489–95. PMID 11121653.
  10. Raney B, Heyn R, Hays DM, Tefft M, Newton WA, Wharam M; et al. (1993). "Sequelae of treatment in 109 patients followed for 5 to 15 years after diagnosis of sarcoma of the bladder and prostate. A report from the Intergroup Rhabdomyosarcoma Study Committee". Cancer. 71 (7): 2387–94. PMID 8453560.
  11. Yeung CK, Ward HC, Ransley PG, Duffy PG, Pritchard J (1994). "Bladder and kidney function after cure of pelvic rhabdomyosarcoma in childhood". Br J Cancer. 70 (5): 1000–3. PMC 2033564. PMID 7947075.
  12. Raney RB, Anderson JR, Kollath J, Vassilopoulou-Sellin R, Klein MJ, Heyn R; et al. (2000). "Late effects of therapy in 94 patients with localized rhabdomyosarcoma of the orbit: Report from the Intergroup Rhabdomyosarcoma Study (IRS)-III, 1984-1991". Med Pediatr Oncol. 34 (6): 413–20. PMID 10842248.
  13. Kaste SC, Hopkins KP, Bowman LC (1995). "Dental abnormalities in long-term survivors of head and neck rhabdomyosarcoma". Med Pediatr Oncol. 25 (2): 96–101. PMID 7603407.
  14. Estilo CL, Huryn JM, Kraus DH, Sklar CA, Wexler LH, Wolden SL; et al. (2003). "Effects of therapy on dentofacial development in long-term survivors of head and neck rhabdomyosarcoma: the memorial sloan-kettering cancer center experience". J Pediatr Hematol Oncol. 25 (3): 215–22. PMID 12621240.

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