Table_1_Prognostic factors of pediatric pelvic and genitourinary rhabdomyosarcoma: An analysis based on SEER database.xls

BackgroundRhabdomyosarcoma (RMS) is the most common soft-tissue sarcomas in children. This study aimed to investigate the prognostic factors of pelvic and genitourinary RMS in children and evaluate the survival outcomes of these children treated with or without radiation therapy (RT).MethodsThe Surveillance, Epidemiology, and End Results Program (SEER) database was required for children with pelvic and genitourinary RMS. Overall survival (OS) and cancer-specific survival (CSS) were analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards models, and propensity score-matched analyses.ResultsFor the 262 patients analyzed, the most common biological subtypes were embryonic (n=209, 79.8%) and alveolar (n=29, 11.1%). Patients with alveolar RMS had the worst prognosis (P < 0.05). The testis (n=122, 46.6%) was the most common location, followed by the urinary bladder (n=57, 21.8%) and prostate (n=48, 18.3%). Uterus RMS had the highest survival rate, followed by testis, urinary bladder, and prostate RMS. Favorable prognostic factors were age at diagnosis < 15 years, non-alveolar histological subtype, early tumor stage (localized/regional), specific sites (uterus and testis), and treatment (cancer-directed surgery and chemotherapy) (P < 0.05). Propensity score-matched analyses comparing the cohorts of patients treated with or without RT demonstrated no significant differences in prognostic survival (OS: P=0.872, CSS: P=0.713).ConclusionThe nomogram constructed based on independent prognostic factors may accurately predict survival rates at 1 and 5 years. Surgery and adjuvant chemotherapy can be effective treatments, but RT fails to guarantee a survival benefit. Therefore, prospective trials evaluating RT for pediatric pelvic and genitourinary RMS are warranted.

背景：横纹肌肉瘤（RMS）是儿童中最常见的软组织肉瘤。本研究旨在探讨儿童盆腔和泌尿生殖道RMS的预后因素，并评估接受或未接受放疗（RT）治疗的这些儿童的生存结果。
方法：本研究需要使用监测、流行病学和结果（SEER）数据库中的盆腔和泌尿生殖道RMS儿童的资料。通过Kaplan-Meier方法、log-rank检验、Cox比例风险模型和倾向评分匹配分析，分析了总生存期（OS）和癌症特异性生存期（CSS）。
结果：在分析的262名患者中，最常见的生物学亚型为胚胎型（n=209，占79.8%）和肺泡型（n=29，占11.1%）。肺泡型RMS患者的预后最差（P < 0.05）。最常见的发病部位为睾丸（n=122，占46.6%），其次是膀胱（n=57，占21.8%）和前列腺（n=48，占18.3%）。子宫RMS的生存率最高，其次是睾丸、膀胱和前列腺RMS。有利的预后因素包括诊断时年龄小于15岁、非肺泡型组织学亚型、早期肿瘤阶段（局部/区域）、特定部位（子宫和睾丸）以及治疗（靶向癌症的手术和化疗）（P < 0.05）。倾向评分匹配分析比较接受或未接受RT治疗的两组患者队列，在预后生存率方面没有发现显著差异（OS：P=0.872，CSS：P=0.713）。
结论：基于独立预后因素的nomogram可准确预测1年和5年的生存率。手术和辅助化疗是有效的治疗方法，但放疗未能保证生存益处。因此，有必要进行前瞻性试验，以评估放疗在儿童盆腔和泌尿生殖道RMS中的应用价值。