Clinical characteristics and outcomes of infants compared with children diagnosed with rhabdomyosarcoma: Analysis of surveillance, epidemiology and end results data from 2000 to 2016.
Clinical characteristics and outcomes of infants compared with children diagnosed with rhabdomyosarcoma: Analysis of surveillance, epidemiology and end results data from 2000 to 2016.
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DOI：
10.1002/cnr2.1503
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发表时间：
2022-05
期刊：
影响因子：
1.7
通讯作者：
Goldsby, Robert E.
中科院分区：
文献类型：
--
作者：
Rees, Hannah D.;Hills, Nancy K.;Sabnis, Amit J.;Tulpule, Asmin B.;Shimotake, Tom K.;Goldsby, Robert E.
横纹肌肉瘤（RMS）是儿童最常见的软组织肉瘤，但很少发生在婴儿（<1岁）。从历史上看，与其他儿科年龄组相比，RMS婴儿的总体生存率更差。本研究的目的是评估与生存率相关的临床特征和治疗因素，比较1-9岁诊断为RMS的婴儿和儿童。使用SEER数据库确定了2000年至2016年期间诊断为RMS的10岁以下儿童。描述性统计用于评估婴儿和儿童RMS的人口统计学、临床和治疗特征。Kaplan-Meier估计和考克斯比例风险回归用于评估与生存相关的因素。年龄<1岁与死亡风险增加独立相关。与1-9岁的儿童相比，接受标准治疗的婴儿较少，即化疗联合局部控制（手术和/或放疗; 86.8% vs. 75.7%; p = 0.009）。在比较特定治疗方式（单独使用或与其他方式联合使用）的频率时，与1-9岁儿童相比，婴儿接受放射治疗的可能性较低（34.0 vs. 66.4%; p <0.001），接受手术的可能性较高（68.9 vs. 57.5%; p = 0.02）。在各年龄组中，化疗联合局部控制与死亡率降低显著相关。肺泡组织学、转移性疾病和西班牙裔种族与生存率呈负相关。与1-9岁相比，<1岁是RMS死亡率增加的独立危险因素。较少的婴儿接受化疗联合局部控制治疗，该治疗与所有年龄组的最佳生存率相关。应进一步探讨导致生存差异的其他因素。
Rhabdomyosarcoma (RMS) is the most common soft‐tissue sarcoma of childhood, but occurs infrequently in infants (<1 year). Historically, infants with RMS have worse overall survival compared to other pediatric age groups. This study aims to assess the clinical features and treatment factors associated with survival comparing infants to children aged 1–9 years diagnosed with RMS. Children aged <10 years diagnosed with RMS between 2000 and 2016 were identified using the SEER database. Descriptive statistics were used to assess demographic, clinical, and treatment characteristics of infants and children with RMS. Kaplan–Meier estimates and Cox proportional hazards regression were performed to assess for factors associated with survival. Age <1 year was independently associated with an increased risk of mortality. Compared to children aged 1–9 years, fewer infants received standard of care therapy, that is, chemotherapy combined with local control (surgery and/or radiation; 86.8 vs. 75.7%; p = .009). In comparing the frequency of specific treatment modalities (used alone or in combination with other modalities), infants were less likely to receive radiation therapy (34.0 vs. 66.4%; p < .001) and more likely to receive surgery (68.9 vs. 57.5%; p = .02) than children aged 1–9 years. Across age groups, chemotherapy combined with local control was significantly associated with reduced mortality. Alveolar histology, metastatic disease, and Hispanic ethnicity were negatively associated with survival. Age of <1 year was an independent risk factor for increased mortality from RMS compared to ages 1–9 years. Fewer infants were treated with chemotherapy combined with local control, the therapy associated with best survival in all age groups. Other factors contributing to differences in survival should be further explored.
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