Prognostic factors in pediatric head and neck rhabdomyosarcoma: a 30-year retrospective study in Brazil.
In a 64-patient retrospective Brazilian cohort treated from 1990 to 2022, head-and-neck location was not prognostic for pediatric rhabdomyosarcoma, whereas age, risk classification, relapse, lesion size, histological subtype, surgery, and radiotherapy showed associations with selected survival outcomes.
Open original publication →What the AI sees
In a 64-patient retrospective Brazilian cohort treated from 1990 to 2022, head-and-neck location was not prognostic for pediatric rhabdomyosarcoma, whereas age, risk classification, relapse, lesion size, histological subtype, surgery, and radiotherapy showed associations with selected survival outcomes.
Research significance
The evidence supports potential refinement of prognostic stratification using age, established risk classification, tumor size, and histological subtype; it only suggests—not proves—that treatment planning involving surgery or radiotherapy might affect outcomes, because the retrospective associations cannot establish treatment benefit or causality.
Source abstract
This study aimed to evaluate the survival outcomes of pediatric patients with head and neck (HN) rhabdomyosarcoma (RMS) treated at a reference center in Brazil, comparing them with those of patients with non-head and neck (NHN) RMS. Additionally, it sought to identify the clinical-pathological variables, histological subtypes, and antineoplastic therapy regimens that significantly influence patient prognosis. The study included RMS patients treated between 1990 and 2022. Statistical analyses comprised t-tests, chi-square tests, Kaplan-Meier survival analysis, and Cox regression for overall survival (OS), disease-free survival (DFS), and event-free survival (EFS). A total of 64 patients (60.9% male) were included, with head and neck tumors being the most common presentation. Prognostic factors associated with OS included age ≥ 10 years, intermediate-risk classification, tumor relapse, and surgery. DFS was significantly influenced by age ≥10 years and high-risk classification, while EFS was associated with lesion size, histological subtype, and radiotherapy. In conclusion, anatomical site was not a significant prognostic factor. Age and risk classification significantly influenced OS and DFS, while histological subtype emerged as an independent factor for EFS. This study, conducted at a reference center in Latin America with a 30-year history of care, provides clinically relevant insights by identifying specific prognostic factors for RMS in Brazilian pediatric patients. These findings enable comparisons with international data and contribute to planning health interventions.