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Initial patient characteristics can predict pattern and risk of relapse in localized rhabdomyosarcoma

Dantonello, Tobias M.; Int-Veen, Christoph; Winkler, Peter; Leuschner, Ivo; Schuck, Andreas; Schmidt, Bernhard F.; Lochbuehler, Helmut; Kirsch, Sylvia; Hallmen, Erika and Veit-Friedrich, Iris, et al. (2008) In Journal of Clinical Oncology 26(3). p.406-413
Abstract
Purpose Evaluation of primary tumor-, treatment-, and patient-related factors predicting relapse pattern, risk, and survival after relapse with the aim to design a risk-adapted, tumor- directed surveillance program for patients with localized rhabdomyosarcoma (RMS). Patients and Methods One thousand one hundred sixty-four patients with nonmetastatic RMS achieved complete remission at the end of multimodal therapy in the consecutive trials of the Cooperative Weichteilsarkom Studiengruppe (CWS)-81, CWS-86, CWS-91, and CWS-96 between 1980 and 2002 ( median follow-up, 5 years). Three hundred thirty-seven of these individuals developed either locoregional, metastatic, or combined relapses. Predictive factors for relapse, its pattern, and... (More)
Purpose Evaluation of primary tumor-, treatment-, and patient-related factors predicting relapse pattern, risk, and survival after relapse with the aim to design a risk-adapted, tumor- directed surveillance program for patients with localized rhabdomyosarcoma (RMS). Patients and Methods One thousand one hundred sixty-four patients with nonmetastatic RMS achieved complete remission at the end of multimodal therapy in the consecutive trials of the Cooperative Weichteilsarkom Studiengruppe (CWS)-81, CWS-86, CWS-91, and CWS-96 between 1980 and 2002 ( median follow-up, 5 years). Three hundred thirty-seven of these individuals developed either locoregional, metastatic, or combined relapses. Predictive factors for relapse, its pattern, and postrelapse survival were analyzed. Results Age, histology, tumor size, tumor site, postsurgical stage, and omission of radiotherapy were identified as factors associated with an increased relapse risk in multivariate analyses. Relapse rates did not differ among the CWS trials. Median time to relapse was 1.43 years from first diagnosis ( range, 0.13 to 13.5 years). There were 217 locoregional, 72 metastatic, and 48 combined recurrences. Only two patients developed metastases more than 4 years after diagnosis, and both had combined recurrences. Five-year postrelapse survival was 24%. Patient subsets with consistent relapse pattern, risk, and postrelapse survival rates were identified on the basis of histologic subtype and tumor size. Conclusion Initial patient and tumor characteristics predict pattern and risk of relapse and also correlate with postrelapse survival probabilities. In localized RMS, tumor- directed follow-up should focus on the primary site. Screening for metastatic relapse may not be necessary more than 4 years after diagnosis. The identification of subgroups with distinctive pattern and risk of relapse may be used to develop risk-adapted, tumor- directed guidance for detection of recurrent disease in localized RMS. (Less)
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Journal of Clinical Oncology
volume
26
issue
3
pages
406 - 413
publisher
American Society of Clinical Oncology
external identifiers
  • wos:000254177200014
  • scopus:38649116902
ISSN
1527-7755
DOI
10.1200/JCO.2007.12.2382
language
English
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yes
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a1f9d465-a32a-4491-8a47-a415e97b5696 (old id 1184976)
date added to LUP
2008-09-02 14:46:15
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2017-11-05 03:48:43
@article{a1f9d465-a32a-4491-8a47-a415e97b5696,
  abstract     = {Purpose Evaluation of primary tumor-, treatment-, and patient-related factors predicting relapse pattern, risk, and survival after relapse with the aim to design a risk-adapted, tumor- directed surveillance program for patients with localized rhabdomyosarcoma (RMS). Patients and Methods One thousand one hundred sixty-four patients with nonmetastatic RMS achieved complete remission at the end of multimodal therapy in the consecutive trials of the Cooperative Weichteilsarkom Studiengruppe (CWS)-81, CWS-86, CWS-91, and CWS-96 between 1980 and 2002 ( median follow-up, 5 years). Three hundred thirty-seven of these individuals developed either locoregional, metastatic, or combined relapses. Predictive factors for relapse, its pattern, and postrelapse survival were analyzed. Results Age, histology, tumor size, tumor site, postsurgical stage, and omission of radiotherapy were identified as factors associated with an increased relapse risk in multivariate analyses. Relapse rates did not differ among the CWS trials. Median time to relapse was 1.43 years from first diagnosis ( range, 0.13 to 13.5 years). There were 217 locoregional, 72 metastatic, and 48 combined recurrences. Only two patients developed metastases more than 4 years after diagnosis, and both had combined recurrences. Five-year postrelapse survival was 24%. Patient subsets with consistent relapse pattern, risk, and postrelapse survival rates were identified on the basis of histologic subtype and tumor size. Conclusion Initial patient and tumor characteristics predict pattern and risk of relapse and also correlate with postrelapse survival probabilities. In localized RMS, tumor- directed follow-up should focus on the primary site. Screening for metastatic relapse may not be necessary more than 4 years after diagnosis. The identification of subgroups with distinctive pattern and risk of relapse may be used to develop risk-adapted, tumor- directed guidance for detection of recurrent disease in localized RMS.},
  author       = {Dantonello, Tobias M. and Int-Veen, Christoph and Winkler, Peter and Leuschner, Ivo and Schuck, Andreas and Schmidt, Bernhard F. and Lochbuehler, Helmut and Kirsch, Sylvia and Hallmen, Erika and Veit-Friedrich, Iris and Bielack, Stefan S. and Niggli, Felix and Kazanowska, Bernarda and Ladenstein, Ruth and Wiebe, Thomas and Klingebiel, Thomas and Treuner, Joern and Koscielniak, Ewa},
  issn         = {1527-7755},
  language     = {eng},
  number       = {3},
  pages        = {406--413},
  publisher    = {American Society of Clinical Oncology},
  series       = {Journal of Clinical Oncology},
  title        = {Initial patient characteristics can predict pattern and risk of relapse in localized rhabdomyosarcoma},
  url          = {http://dx.doi.org/10.1200/JCO.2007.12.2382},
  volume       = {26},
  year         = {2008},
}