Prognosis and survival for rhabdomyosarcoma
If your child has rhabdomyosarcoma (RMS), you may have questions about the prognosis (outcome). A prognosis is the doctor's best estimate of how cancer will affect someone and how it will respond to treatment. Prognosis and survival depend on many things. Only a doctor familiar with a child's medical history, the type, stage and characteristics of the cancer, the treatments chosen and the response to treatment can put all of this information together with survival statistics to arrive at a prognosis.
A prognostic factor is an aspect of the cancer or a characteristic of the child that the doctor will consider when making a prognosis. A predictive factor influences how a cancer will respond to a certain treatment. Prognostic and predictive factors are often discussed together. They both play a part in deciding on a treatment plan and a prognosis.
The following are prognostic and predictive factors for RMS.
Age
Children between the ages of 1 and 9 years tend to have a better prognosis than children 10 years of age and older or younger than 1 year.
Where the tumour started
Where the tumour started in the body can affect the prognosis.
There is a better prognosis with tumours that begin in:
- the area around the eye (called the orbit)
- areas of the head and neck not near the tissue surrounding the brain and spinal cord (called non-parameningeal areas)
- organs of the
genitourinary system (except the kidney, bladder and prostate) - the gallbladder or the bile ducts
Tumours in any other location have a poorer prognosis. This includes tumours that begin in:
- the bladder, prostate, arm, leg, hand or foot
- areas of the head and neck near the
meninges (called parameningeal areas)
Tumours that start in the arm or leg tend to spread to other areas earlier than tumours that start in other parts of the body, so they have a poorer prognosis.
Tumour size
Children with tumours that are 5 cm or less in diameter have a better prognosis than children with larger tumours.
If the cancer has spread
Children with cancer that has already spread, or metastasized, to distant parts of the body when it is diagnosed have a poorer prognosis. Children with cancer that has spread to regional lymph nodes have a poorer prognosis than children with cancer that hasn't spread to any lymph nodes. Children with cancer in the brain and spinal cord (called the central nervous system, or CNS) have a poor prognosis.
If the tumour can be completely removed
How much cancer is left behind after surgery is also an important prognostic factor. Children with tumours that can be completely removed usually have a better prognosis.
Type of rhabdomyosarcoma
Alveolar tumours tend to be more aggressive and have a poorer prognosis than embryonal tumours.