Improved outcome for patients with middle ear rhabdomyosarcoma: A children's oncology group study

D. S. Hawkins, J. R. Anderson, C. N. Paidas, M. D. Wharam, S. J. Qualman, A. S. Pappo, K. Scott Baker, W. M. Crist

Research output: Contribution to journalArticle

Abstract

The goal of this study was to define the clinical features and optimal therapy for children and adolescents with middle ear (ME) rhabdomyosarcoma (RMS). Patients and Methods: We reviewed demographic data, clinical features, therapy (including chemotherapy, surgery, and radiation), and outcome for the 179 eligible patients with ME RMS who were enrolled onto Intergroup Rhabdomyosarcoma Studies (IRS) I through IV or pilot studies between November 1972 and December 1997. Results: Most patients were younger than 10 years old (90%), and 63% were male. Because of the parameningeal location, most tumors were not resected before chemotherapy (group I, <1%; group II, 4%; group III, 84%; group IV, 12%). Although most tumors were locally invasive (T2, 89%), the majority were small (≤ 5 cm, 66%), lacked nodal metastases (NO, 86%), and had embryonal histology (85%). The 5-year failure-free survival (FFS) and overall survival (OS) estimates were 67% and 72%, respectively. Both FFS and OS improved significantly over the course of IRS I through IV (3-year FFS and OS: IRS-I, 42% and 42%; IRS-II, 70% and 74%; IRS-III, 65% and 72%; IRS-IV pilot, 81% and 96%; IRS-IV, 88% and 88%, P <.001). Lower clinical group or stage and smaller tumor size were associated with better outcome. Age, sex, tumor invasiveness, and nodal metastases were not predictive of outcome. Conclusion: Patients with ME RMS generally present with small, unresectable, invasive tumors at a site traditionally considered prognostically unfavorable. Nevertheless, such patients have benefited markedly from improvements in multimodal, risk-based therapy during the course of IRS I through IV, and with contemporary therapy, most are cured.

Original languageEnglish (US)
Pages (from-to)3073-3079
Number of pages7
JournalJournal of Clinical Oncology
Volume19
Issue number12
StatePublished - Jun 15 2001
Externally publishedYes

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Rhabdomyosarcoma
Middle Ear
Survival
Neoplasms
Neoplasm Metastasis
Drug Therapy
Therapeutics
Histology
Demography
Radiation

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Hawkins, D. S., Anderson, J. R., Paidas, C. N., Wharam, M. D., Qualman, S. J., Pappo, A. S., ... Crist, W. M. (2001). Improved outcome for patients with middle ear rhabdomyosarcoma: A children's oncology group study. Journal of Clinical Oncology, 19(12), 3073-3079.

Improved outcome for patients with middle ear rhabdomyosarcoma : A children's oncology group study. / Hawkins, D. S.; Anderson, J. R.; Paidas, C. N.; Wharam, M. D.; Qualman, S. J.; Pappo, A. S.; Scott Baker, K.; Crist, W. M.

In: Journal of Clinical Oncology, Vol. 19, No. 12, 15.06.2001, p. 3073-3079.

Research output: Contribution to journalArticle

Hawkins, DS, Anderson, JR, Paidas, CN, Wharam, MD, Qualman, SJ, Pappo, AS, Scott Baker, K & Crist, WM 2001, 'Improved outcome for patients with middle ear rhabdomyosarcoma: A children's oncology group study', Journal of Clinical Oncology, vol. 19, no. 12, pp. 3073-3079.
Hawkins DS, Anderson JR, Paidas CN, Wharam MD, Qualman SJ, Pappo AS et al. Improved outcome for patients with middle ear rhabdomyosarcoma: A children's oncology group study. Journal of Clinical Oncology. 2001 Jun 15;19(12):3073-3079.
Hawkins, D. S. ; Anderson, J. R. ; Paidas, C. N. ; Wharam, M. D. ; Qualman, S. J. ; Pappo, A. S. ; Scott Baker, K. ; Crist, W. M. / Improved outcome for patients with middle ear rhabdomyosarcoma : A children's oncology group study. In: Journal of Clinical Oncology. 2001 ; Vol. 19, No. 12. pp. 3073-3079.
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abstract = "The goal of this study was to define the clinical features and optimal therapy for children and adolescents with middle ear (ME) rhabdomyosarcoma (RMS). Patients and Methods: We reviewed demographic data, clinical features, therapy (including chemotherapy, surgery, and radiation), and outcome for the 179 eligible patients with ME RMS who were enrolled onto Intergroup Rhabdomyosarcoma Studies (IRS) I through IV or pilot studies between November 1972 and December 1997. Results: Most patients were younger than 10 years old (90{\%}), and 63{\%} were male. Because of the parameningeal location, most tumors were not resected before chemotherapy (group I, <1{\%}; group II, 4{\%}; group III, 84{\%}; group IV, 12{\%}). Although most tumors were locally invasive (T2, 89{\%}), the majority were small (≤ 5 cm, 66{\%}), lacked nodal metastases (NO, 86{\%}), and had embryonal histology (85{\%}). The 5-year failure-free survival (FFS) and overall survival (OS) estimates were 67{\%} and 72{\%}, respectively. Both FFS and OS improved significantly over the course of IRS I through IV (3-year FFS and OS: IRS-I, 42{\%} and 42{\%}; IRS-II, 70{\%} and 74{\%}; IRS-III, 65{\%} and 72{\%}; IRS-IV pilot, 81{\%} and 96{\%}; IRS-IV, 88{\%} and 88{\%}, P <.001). Lower clinical group or stage and smaller tumor size were associated with better outcome. Age, sex, tumor invasiveness, and nodal metastases were not predictive of outcome. Conclusion: Patients with ME RMS generally present with small, unresectable, invasive tumors at a site traditionally considered prognostically unfavorable. Nevertheless, such patients have benefited markedly from improvements in multimodal, risk-based therapy during the course of IRS I through IV, and with contemporary therapy, most are cured.",
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AU - Scott Baker, K.

AU - Crist, W. M.

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