Rhabdomyosarcoma in Adolescents and Young Adults: A 25-Year Review at Nationwide Children's Hospital

Purpose: To review a single institution's experience with rhabdomyosarcoma (RMS) in the adolescent and young adult (AYA) age group as compared to younger patients with RMS in regard to patient characteristics at diagnosis, treatment outcome, and treatment toxicities. Patients and Methods: A retrospective 25-year review was conducted of all patients diagnosed with RMS who received treatment at Nationwide Children's Hospital between 1984 and 2008. Data were collected on patient characteristics at diagnosis, including vital status, histology, primary tumor location, metastatic status, modalities of treatment, and toxicities of therapy. Results: Twenty-one AYAs (aged 15-25 at diagnosis) were treated at Nationwide Children's Hospital in the 25-year time period, compared to 72 patients less than 15 years of age. Of these, currently 63.6% of patients aged 15 or older have died of their disease compared to only 33.7% of those aged 14 or younger. Higher percentages of alveolar histology, unfavorable location of primary tumor, and distant metastases were noted in the AYA patients. The percentage of AYA patients experiencing delays in chemotherapy or vincristine toxicity was not significantly different from that in younger patients. Conclusion: At our institution, survival for AYA patients with RMS was poor compared to younger children. In this cohort, the survival difference appears to be a function of a higher percentage of patients with unfavorable disease characteristics, rather than difficulty tolerating chemotherapy. Further study is necessary to define the biology and characteristics of RMS better in this population.