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Zhao D, Zhou F, Liu W, Huang Z, Xu X, Zheng B, Liu C, Bai C, Liu J, Sun Y, Wang W, Xiao S. Adult head and neck rhabdomyosarcoma: radiotherapy- based treatment, outcomes, and predictors of survival. BMC Cancer 2024; 24:340. [PMID: 38486204 PMCID: PMC10938762 DOI: 10.1186/s12885-024-12079-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2023] [Accepted: 03/04/2024] [Indexed: 03/18/2024] Open
Abstract
BACKGROUND Adult head and neck rhabdomyosarcoma (HNRMS) is an exceptionally rare malignancy, and there is a paucity of data and research dedicated to understanding its characteristics and management in adult populations. This study aimed to assess the outcomes and identify survival predictors in adult HNRMS. METHODS We retrospectively evaluated 42 adult patients (> 16 years) with HNRMS who received radiotherapy (RT)-based treatment at our institute between 2008 and 2022. We analysed the clinical characteristics and prognosis of these patients, including the locoregional recurrence-free survival (LRFS), progression-free survival (PFS), and overall survival (OS), using the Kaplan-Meier method. The chi-square and Fisher's exact tests were used to analyse differences between groups for dichotomous and categorical variables, respectively. Survival rates were calculated using the Kaplan-Meier method. Prognostic variables were assessed through univariate Cox analyses. RESULTS The median patient age was 28 years (range, 16-82 years). Alveolar RMS was the most common histological type, observed in 21 patients (50.0%), followed by embryonal in 16 patients (38.1%). The anatomic sites of origin were orbital in one (2.4%), parameningeal in 26 (61.9%), and non-orbital/non-parameningeal in 15 (35.7%) patients. Nineteen patients (45.2%) had regional lymph node metastasis, and five patients (11.9%) presented with distant metastatic disease. Distant metastasis (n = 17) was the primary cause of treatment failure. At a median follow-up of 47.0 months, the 5-year LRFS, PFS, and OS rates were 69.0%, 39.7%, and 41.0%, respectively. Univariate analysis revealed that tumour size, lymph node involvement, and the local treatment pattern (surgery and RT vs. RT alone) were significant predictors of survival. CONCLUSIONS The main failure pattern in patients with HNRMS receiving RT-based treatment was distant metastasis. Tumour size > 5 cm and lymph node involvement were predictors of worse LRFS. Multimodality local treatment, combining surgery and RT, is effective and provides survival benefits.
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Affiliation(s)
- Dan Zhao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Fang Zhou
- Department of Radiotherapy, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Shandong, P.R. China
| | - Weixin Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Zhou Huang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Xiaolong Xu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Baomin Zheng
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Changqing Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Chujie Bai
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Bone and Soft Tissue Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Jiayong Liu
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Bone and Soft Tissue Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Yan Sun
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China
| | - Weihu Wang
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China.
| | - Shaowen Xiao
- Key Laboratory of Carcinogenesis and Translational Research (Ministry of Education/Beijing), Department of Radiation Oncology, Peking University Cancer Hospital & Institute, Peking University, 100142, Beijing, P.R. China.
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Apte SS, Mor E, Mitchell C, Gyorki DE. Practical Management of Adult Ultra-Rare Primary Retroperitoneal Soft Tissue Sarcoma: A Focus on Perivascular Epithelioid Tumours and Extraosseous Ewing Sarcoma. Curr Oncol 2023; 30:5953-5972. [PMID: 37504306 PMCID: PMC10377910 DOI: 10.3390/curroncol30070445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2023] [Revised: 06/16/2023] [Accepted: 06/20/2023] [Indexed: 07/29/2023] Open
Abstract
With the exception of well-differentiated liposarcoma, dedifferentiated liposarcoma, leiomyosarcoma, solitary fibrous tumour, malignant peripheral nerve sheath tumour, and undifferentiated pleomorphic sarcoma, the majority of the ≈70 histologic subtypes of retroperitoneal sarcoma are defined as 'ultra-rare' sarcomas, with an incidence of ≤1-5/1,000,000 persons/year. For most of these ultra-rare RPS subtypes, diagnosis and treatment follows international guidelines for the management of more common RPS histologies, with en bloc surgical resection as the mainstay of curative treatment, and enrolment in clinical trials where possible. Because the treatment of RPS is heavily driven by histology, the surgeon must be familiar with specific issues related to the diagnosis and management of ultra-rare sarcoma subtypes. Expert radiological and surgeon reviews are required to differentiate similarly presenting tumours where surgery can be avoided (e.g., angiomyolipoma), or where upfront systemic therapy is indicated (e.g., extraosseous Ewing's sarcoma). Thus, the management of all retroperitoneal sarcomas should occur at a sarcoma referral centre, with a multidisciplinary team of experts dedicated to the surgical and medical management of these rare tumours. In this focused review, we highlight how diagnosis and management of the ultra-rare primary RPS histologies of malignant perivascular epithelioid cell tumour (PEComa), extraosseous Ewing sarcoma (EES), extraosseous osteosarcoma (EOS), and rhabdomyosarcoma (RMS) critically diverge from the management of more common RPS subtypes.
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Affiliation(s)
- Sameer S Apte
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
- Division of General Surgery, The Ottawa Hospital, Ottawa, ON K1H 8L6, Canada
| | - Eyal Mor
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
| | - Catherine Mitchell
- Division of Pathology, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
| | - David E Gyorki
- Division of Cancer Surgery, Peter MacCallum Cancer Centre, Melbourne, VIC 3000, Australia
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Díez-Montiel A, Antúnez-Conde R, Navarro Cuéllar C, Tousidonis Rial M, Salmerón JI, Bonsfills N, Pujol CA, Serrano FA, Ochandiano S. Embryonal Rhabdomyosarcoma of the Tongue in Adults. Life (Basel) 2023; 13:1255. [PMID: 37374040 DOI: 10.3390/life13061255] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 05/10/2023] [Accepted: 05/22/2023] [Indexed: 06/29/2023] Open
Abstract
(1) Background: Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the first two decades of life. One third of cases appear in the head and neck, with 60% of these being embryonal type. RMS is extremely rare in adults, comprising only 1% of adult malignancies, and of those, only 3.3% are rhabdomyosarcomas. (2) Case report: A 46 y.o. male presented with a 1 cm exophytic pediculated painless lesion on the dorsum of his tongue, with progressive growth for 3 months. An excisional biopsy revealed an "embryonal rhabdomyosarcoma with fusocellular areas, with negative rearrangement for gen FOXO1A, negative MDM2 (only focal positivity), and positive INI-1". Subsequent contrast-enhanced MRI concluded the presence of a lesion with imprecise margins in the right half-tongue, 15 × 8 × 7 mm (longitudinal × transverse × craniocaudal), compatible with a sarcoma. The patient underwent a partial centrolingual glossectomy followed by reconstruction with a buccinator muscle local flap. After surgery, he received chemotherapy with eight cycles of VAC (vincristine, actinomycin, and cyclophosphamide) protocol. The patient is now disease free after 42 months, with good tongue function. (3) Discussion and conclusions: Embryonal RMS is an extremely rare sarcoma in adults, and the location in the tongue is even more exceptional (only two more similar cases are reported in the literature). The prognosis in adults is significantly poorer than in children. A complete margin-free resection with an adequate chemotherapy protocol is the treatment of choice in cases such as these.
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Affiliation(s)
- Alberto Díez-Montiel
- Department of Oral and Maxillofacial Surgery, Instituto de Investigación Sanitaria Gregorio Marañon (liSGM), Gregorio Marañon General University Hospital, 28007 Madrid, Spain
| | - Raúl Antúnez-Conde
- Department of Oral and Maxillofacial Surgery, Instituto de Investigación Sanitaria Gregorio Marañon (liSGM), Gregorio Marañon General University Hospital, 28007 Madrid, Spain
| | - Carlos Navarro Cuéllar
- Department of Oral and Maxillofacial Surgery, Instituto de Investigación Sanitaria Gregorio Marañon (liSGM), Gregorio Marañon General University Hospital, 28007 Madrid, Spain
| | - Manuel Tousidonis Rial
- Department of Oral and Maxillofacial Surgery, Instituto de Investigación Sanitaria Gregorio Marañon (liSGM), Gregorio Marañon General University Hospital, 28007 Madrid, Spain
| | - José Ignacio Salmerón
- Department of Oral and Maxillofacial Surgery, Instituto de Investigación Sanitaria Gregorio Marañon (liSGM), Gregorio Marañon General University Hospital, 28007 Madrid, Spain
| | - Nuria Bonsfills
- ICIRE Institute for Reconstructive and Aesthetic Surgery, 28009 Madrid, Spain
| | - Carolina Agra Pujol
- Department of Pathology, Gregorio Marañon General University Hospital, 28007 Madrid, Spain
| | | | - Santiago Ochandiano
- Department of Oral and Maxillofacial Surgery, Instituto de Investigación Sanitaria Gregorio Marañon (liSGM), Gregorio Marañon General University Hospital, 28007 Madrid, Spain
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Muacevic A, Adler JR, Baloch NU, Jhatial MA, Waheed M, Fasih S, Kalsoom Awan UE. Baseline Characteristics, Prognostic Factors, and Treatment Outcomes for Adult Patients With Rhabdomyosarcoma (RMS). Cureus 2022; 14:e32961. [PMID: 36712747 PMCID: PMC9875868 DOI: 10.7759/cureus.32961] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/26/2022] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma of childhood, while in adults it is one of the rarer tumors. Its prognosis is better in children with current treatment modalities; however, it carries poorer prognosis in adults. Recent data on adult RMS is scarce from our part of world. We report outcomes of adult patients with RMS, and with 40 patients; it is the first study to publish such a large data from Pakistan. METHODS This was a retrospective study that included 64 adult patients aged 18 years and older. After data extraction and scrutiny, a total of 40 patients were segregated with diagnosis of RMS of various varieties who were treated and followed up subsequently. International Business Machines (IBM) Statistical Package for Social Sciences (SPSS), version 26 (IBM Corp., Armonk, NY) was used to evaluate all of the gathered data. RESULTS Embryonal RMS (ERMS) was the most common subtype. Factors favoring better overall survival (OS) at 5 years were absence of nodal and distal metastases, treatment with surgery, margin negative resection, and absence of residual disease on postoperative imaging. Adjuvant radiation therapy (XRT) for positive resection margins as well as for residual disease on postoperative imaging also favored better OS at 5 years. Chemotherapy did impart a trend towards better OS; however, it was not significant. Histopathologic subtype and tumor size did not have any significant impact on outcomes. Median progression free survival (PFS) was 11 months and median OS was 15 months. CONCLUSIONS Adult RMS is a rare disease entity with widely heterogeneous clinical picture and poorer outcomes as compared to the disease of childhood and adolescence. Further prospective studies with larger sample size are required to establish role of patient, disease, and treatment-related factors affecting outcomes in our population.
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De Vita A, Vanni S, Fausti V, Cocchi C, Recine F, Miserocchi G, Liverani C, Spadazzi C, Bassi M, Gessaroli M, Campobassi A, De Luca G, Pieri F, Farnedi A, Franchini E, Ferrari A, Domizio C, Cavagna E, Gurrieri L, Bongiovanni A, Riva N, Calpona S, Di Menna G, Debonis SA, Ibrahim T, Mercatali L. Deciphering the Genomic Landscape and Pharmacological Profile of Uncommon Entities of Adult Rhabdomyosarcomas. Int J Mol Sci 2021; 22:ijms222111564. [PMID: 34768995 PMCID: PMC8584142 DOI: 10.3390/ijms222111564] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 10/20/2021] [Accepted: 10/21/2021] [Indexed: 12/23/2022] Open
Abstract
Adult rhabdomyosarcoma (RMS) represents an uncommon entity with an incidence of less than 3% of all soft tissue sarcomas (STS). Consequently, the natural history and the clinical management of this disease are infrequently reported. In order to fill this gap, we investigated the molecular biology of an adult RMS case series. The expression of epithelial mesenchymal transition-related gene and chemoresistance-related gene panels were evaluated. Moreover, taking advantage of our STS translational model combining patient-derived primary culture and 3D-scaffold, the pharmacological profile of an adult head and neck sclerosing RMS was assessed. Furthermore, NGS, microsatellite instability, and in silico analyses were carried out. RT-PCR identified the upregulation of CDH1, SLUG, MMP9, RAB22a, S100P, and LAPTM4b, representing promising biomarkers for this disease. Pharmacological profiling showed the highest sensitivity with anthracycline-based regimen in both 2D and 3D culture systems. NGS analysis detected RAB3IP-HMGA2 in frame gene rearrangement and FGFR4 mutation; microsatellite instability analysis did not detect any alteration. In silico analysis confirmed the mutation of FGFR4 as a promising marker for poor prognosis and a potential therapeutic target. We report for the first time the molecular and pharmacological characterization of rare entities of adult head and neck and posterior trunk RMS. These preliminary data could shed light on this poorly understood disease.
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Affiliation(s)
- Alessandro De Vita
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
- Correspondence: (A.D.V.); (C.C.); Tel.: +39-0543-73-9239 (A.D.V. & C.C.); Fax: +39-0543-73-9221 (A.D.V. & C.C.)
| | - Silvia Vanni
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Valentina Fausti
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Claudia Cocchi
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
- Correspondence: (A.D.V.); (C.C.); Tel.: +39-0543-73-9239 (A.D.V. & C.C.); Fax: +39-0543-73-9221 (A.D.V. & C.C.)
| | - Federica Recine
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
- Medical Oncology Unit, Azienda Ospedaliera “San Giovanni Addolorata”, 00184 Roma, Italy
| | - Giacomo Miserocchi
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Chiara Liverani
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Chiara Spadazzi
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Massimo Bassi
- Oral and Maxillofacial Surgery Unit, “Maurizio Bufalini” Hospital, 47521 Cesena, Italy; (M.B.); (M.G.); (A.C.)
| | - Manlio Gessaroli
- Oral and Maxillofacial Surgery Unit, “Maurizio Bufalini” Hospital, 47521 Cesena, Italy; (M.B.); (M.G.); (A.C.)
| | - Angelo Campobassi
- Oral and Maxillofacial Surgery Unit, “Maurizio Bufalini” Hospital, 47521 Cesena, Italy; (M.B.); (M.G.); (A.C.)
| | - Giovanni De Luca
- Pathology Unit, “Maurizio Bufalini” Hospital, 47521 Cesena, Italy;
| | - Federica Pieri
- Pathology Unit, “Morgagni-Pierantoni” Hospital, 47121 Forlì, Italy; (F.P.); (A.F.)
| | - Anna Farnedi
- Pathology Unit, “Morgagni-Pierantoni” Hospital, 47121 Forlì, Italy; (F.P.); (A.F.)
| | - Eugenia Franchini
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (E.F.); (A.F.); (C.D.)
| | - Anna Ferrari
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (E.F.); (A.F.); (C.D.)
| | - Chiara Domizio
- Biosciences Laboratory, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (E.F.); (A.F.); (C.D.)
| | - Enrico Cavagna
- Department of Diagnostic Imaging, Azienda Unità Sanitaria Locale della Romagna (AUSL Romagna), 47923 Rimini, Italy;
| | - Lorena Gurrieri
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Alberto Bongiovanni
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Nada Riva
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Sebastiano Calpona
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Giandomenico Di Menna
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Silvia Angela Debonis
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Toni Ibrahim
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
| | - Laura Mercatali
- Osteoncology and Rare Tumors Center, IRCCS Istituto Romagnolo per lo Studio dei Tumori (IRST) “Dino Amadori”, 47014 Meldola, Italy; (S.V.); (V.F.); (F.R.); (G.M.); (C.L.); (C.S.); (L.G.); (A.B.); (N.R.); (S.C.); (G.D.M.); (S.A.D.); (T.I.); (L.M.)
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Osman MH, Mohamed RH, Sarhan HM, Park EJ, Baik SH, Lee KY, Kang J. Machine Learning Model for Predicting Postoperative Survival of Patients with Colorectal Cancer. Cancer Res Treat 2021; 54:517-524. [PMID: 34126702 PMCID: PMC9016295 DOI: 10.4143/crt.2021.206] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2021] [Accepted: 06/13/2021] [Indexed: 11/24/2022] Open
Abstract
Purpose Machine learning (ML) is a strong candidate for making accurate predictions, as we can use large amount of data with powerful computational algorithms. We developed a ML based model to predict survival of patients with colorectal cancer (CRC) using data from two independent datasets. Materials and Methods A total of 364,316 and 1,572 CRC patients were included from the Surveillance, Epidemiology, and End Results (SEER) and a Korean dataset, respectively. As SEER combines data from 18 cancer registries, internal validation was done using 18-Fold-Cross-Validation then external validation was performed by testing the trained model on the Korean dataset. Performance was evaluated using area under the receiver operating characteristic curve (AUROC), sensitivity and positive predictive values. Results Clinicopathological characteristics were significantly different between the two datasets and the SEER showed a significant lower 5-year survival rate compared to the Korean dataset (60.1% vs. 75.3%, p < 0.001). The ML-based model using the Light gradient boosting algorithm achieved a better performance in predicting 5-year-survival compared to American Joint Committee on Cancer stage (AUROC, 0.804 vs. 0.736; p < 0.001). The most important features which influenced model performance were age, number of examined lymph nodes, and tumor size. Sensitivity and positive predictive values of predicting 5-year-survival for classes including dead or alive were reported as 68.14%, 77.51% and 49.88%, 88.1% respectively in the validation set. Survival probability can be checked using the web-based survival predictor (http://colorectalcancer.pythonanywhere.com). Conclusion ML-based model achieved a much better performance compared to staging in individualized estimation of survival of patients with CRC.
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Affiliation(s)
| | | | | | - Eun Jung Park
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Seung Hyuk Baik
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Kang Young Lee
- Department of Surgery, Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
| | - Jeonghyun Kang
- Department of Surgery, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, Korea
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Wang X, Feng J, Li Z, Zhang X, Chen J, Feng G. Characteristics and prognosis of embryonal rhabdomyosarcoma in children and adolescents: An analysis of 464 cases from the SEER database. Pediatr Investig 2020; 4:242-249. [PMID: 33376951 PMCID: PMC7768301 DOI: 10.1002/ped4.12220] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2020] [Accepted: 05/12/2020] [Indexed: 12/25/2022] Open
Abstract
IMPORTANCE As the most common subtype of pediatric rhabdomyosarcoma (RMS), the prognosis of embryonal RMS has rarely been investigated solely. OBJECTIVE To perform a population-based study to characterize the prognosis of embryonal RMS in children and adolescents. METHODS Demographic and clinical features were retrospectively evaluated in selected patients with embryonal RMS registered in the Surveillance, Epidemiology, and End Results (SEER) program from 1988 to 2016. Survival curves were compared using the log-rank test. A multivariate Cox proportional hazards model was developed to assess the impact of each factor on the overall survival. A nomogram was constructed based on the results of Cox regression model. RESULTS A total of 464 patients were included in the analysis, among which 64.6% were male and 70.2% were white patients. About 38.6% and 26.3% of the patients were at 1-4 years and 5-9 years, respectively. Cox analysis showed that patients at age group 5-9 years had the lowest risk of mortality (hazard ratio [HR], 0.277; 95% confidential interval [CI], 0.123-0.620), compared with patients diagnosed at less than 1-year-old, and age group 1-4 years had the second-best prognosis. Patients having distant tumors had significantly higher mortality risk (HR, 4.842; 95% CI, 2.804-8.362) than the patients with localized tumor. Compared with receiving no surgery or radiotherapy, receiving any combination of surgery and radiotherapy would lower the risk of mortality significantly (for surgery without radiotherapy: HR, 0.418; for radiotherapy without surgery: HR, 0.405; and for surgery plus radiotherapy: HR, 0.410). INTERPRETATION Age, stage at diagnosis, and treatment received were found to be the most important predictors of the overall survival of pediatric embryonal RMS.
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Affiliation(s)
- Xinyu Wang
- Big Data and Engineering Research CenterBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Jun Feng
- Department of Surgical OncologyBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Zhe Li
- National Center for Pediatric Cancer SurveillanceBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Xin Zhang
- Big Data and Engineering Research CenterBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Jun Chen
- Big Data and Engineering Research CenterBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
| | - Guoshuang Feng
- Big Data and Engineering Research CenterBeijing Children’s HospitalCapital Medical UniversityNational Center for Children’s HealthBeijingChina
- Beijing Advanced Innovation Center for Big Data‐Based Precision MedicineBeihang University & Capital Medical UniversityBeijingChina
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Amer KM, Thomson JE, Congiusta D, Dobitsch A, Chaudhry A, Li M, Chaudhry A, Bozzo A, Siracuse B, Aytekin MN, Ghert M, Beebe KS. Epidemiology, Incidence, and Survival of Rhabdomyosarcoma Subtypes: SEER and ICES Database Analysis. J Orthop Res 2019; 37:2226-2230. [PMID: 31161653 DOI: 10.1002/jor.24387] [Citation(s) in RCA: 71] [Impact Index Per Article: 14.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2019] [Accepted: 04/23/2019] [Indexed: 02/04/2023]
Abstract
Rhabdomyosarcoma is the most common soft-tissue sarcoma in children and adolescents and accounts for 3% of all pediatric tumors. Subtypes include alveolar, spindle cell, embryonal, mixed-type, pleomorphic, and rhabdomyosarcoma with ganglionic differentiation. The National Cancer Institute's Surveillance, Epidemiology, and End Results (SEER) database was queried for patients diagnosed with any type of rhabdomyosarcoma between 1973 and 2014. Patient demographics, tumor characteristics, and incidence were studied with χ2 analysis. Survival was modeled with Kaplan-Meier survival curves and Cox proportional hazards models were used to assess the effect of age and gender on survival. Pleomorphic subtype had higher grade and larger sized tumors compared to other subtypes (p < 0.05). Pleomorphic and alveolar rhabdomyosarcoma had the worst overall survival with a 26.6% and 28.9% 5-year survival, respectively. Embryonal rhabdomyosarcoma had the highest 5-year survival rate (73.9%). Tumor size was negatively correlated with survival months, indicating patients with larger tumors had shorter survival times (p < 0.05). Presence of higher-grade tumors and metastatic disease at presentation were negatively correlated with survival months (p < 0.05). No significant differences in the survival were found between gender or race between all of the subtypes (p > 0.05). This study highlights key differences in the demographic and survival rates of the different types of rhabdomyosarcoma that can be used for more tailored patient counseling. We also demonstrate that large, population-level databases provide sufficient data that can be used in the analysis of rare tumors. © 2019 Orthopaedic Research Society. Published by Wiley Periodicals, Inc. J Orthop Res 37:2226-2230, 2019.
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Affiliation(s)
- Kamil M Amer
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen Street, Suite D, Newark, New Jersey, 07103
| | | | - Dominick Congiusta
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen Street, Suite D, Newark, New Jersey, 07103
| | - Andrew Dobitsch
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen Street, Suite D, Newark, New Jersey, 07103
| | - Ahmed Chaudhry
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen Street, Suite D, Newark, New Jersey, 07103
| | - Matthew Li
- Department of Education, Lime Tree Bay Ave, West Bay, Cayman Islands
| | - Aisha Chaudhry
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen Street, Suite D, Newark, New Jersey, 07103
| | - Anthony Bozzo
- Department of Surgery, McMaster University Division of Orthopaedic Surgery, Hamilton, Ontario, Canada
| | - Brianna Siracuse
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen Street, Suite D, Newark, New Jersey, 07103
| | - Mahmut Nedim Aytekin
- Department of Orthopedics and Traumatology, Yildirim Beyazit University, Ankara, Turkey
| | - Michelle Ghert
- Department of Surgery, McMaster University Division of Orthopaedic Surgery, Hamilton Health Sciences, Juravinski Hospital and Cancer Center, Hamilton, Ontario, Canada
| | - Kathleen S Beebe
- Department of Orthopaedics, Rutgers New Jersey Medical School, 140 Bergen Street, Suite D, Newark, New Jersey, 07103
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