Nonparameningeal head and neck rhabdomyosarcoma in children and adolescents: Lessons from the consecutive International Society of Pediatric Oncology Malignant Mesenchymal Tumor studies

Head Neck. 2017 Jan;39(1):24-31. doi: 10.1002/hed.24547. Epub 2016 Jul 26.

Abstract

Background: This article reports risk factors and long-term outcome in localized nonparameningeal head and neck rhabdomyosarcomas in children and adolescents from a combined dataset from 3 consecutive international trials.

Methods: Data from 140 children (9.3% of total) prospectively enrolled in the International Society of Pediatric Oncology Malignant Mesenchymal Tumor (SIOP-MMT)-84/89/95 studies were analyzed.

Results: Primary site was: superficial face in 46%; oral cavity (21%); neck (19%); and salivary glands (14%). Local control was achieved in 96%, but 49% relapsed (locoregionally 91%). At median follow-up of 10 years, 5-year overall survival (OS) was 74.7% (67.4% to 81.9%) and event-free survival 48.9% (40.6% to 57.2%), although this improved with successive studies. Radiotherapy (RT) as first-line treatment was independently prognostic for event-free survival (relative risk [RR] = 0.4 [range, 0.2-0.7]; p < .01) even if it did not impact OS (RR = 1 [range, 0.5-2]).

Conclusion: High rates of locoregional relapse were seen in head and neck rhabdomyosarcoma that should be prevented by more frequent use of RT in this primary. © 2016 Wiley Periodicals, Inc. Head Neck 39: 24-31, 2017.

Keywords: International Society of Pediatric Oncology Malignant Mesenchymal Tumor (SIOP-MMT) protocols; children; head and neck rhabdomyosarcoma; radiotherapy; surgery.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Disease-Free Survival
  • Female
  • Head and Neck Neoplasms / mortality
  • Head and Neck Neoplasms / pathology
  • Head and Neck Neoplasms / therapy*
  • Humans
  • Infant
  • Infant, Newborn
  • Male
  • Mesenchymoma / mortality
  • Mesenchymoma / pathology
  • Mesenchymoma / therapy*
  • Neoplasm Recurrence, Local / epidemiology*
  • Retrospective Studies
  • Rhabdomyosarcoma / mortality
  • Rhabdomyosarcoma / pathology
  • Rhabdomyosarcoma / therapy*
  • Risk Factors
  • Survival Rate
  • Treatment Outcome

Supplementary concepts

  • Malignant mesenchymal tumor