Bas Vaarwerk1,2, Gianni Bisogno3, Kieran McHugh4, Hervé J Brisse5, Carlo Morosi6, Nadège Corradini7, Meriel Jenney8, Daniel Orbach5, Julia C Chisholm9, Andrea Ferrari6, Ilaria Zanetti3, Gian Luca De Salvo10, Rick R van Rijn1, Johannes H M Merks1,2. 1. 1 University of Amsterdam, Amsterdam, the Netherlands. 2. 10 Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands. 3. 2 Padova University Hospital, Padova, Italy. 4. 3 Great Ormond Street Hospital for Children, London, United Kingdom. 5. 4 Institut Curie, Paris, France. 6. 5 Istituto Nazionale Tumori Milano, Milan, Italy. 7. 6 Centre Léon Bérard, Lyon, France. 8. 7 Children's Hospital for Wales, Heath Park, Cardiff, United Kingdom. 9. 8 Royal Marsden Hospital, Sutton, United Kingdom. 10. 9 Istituto Oncologico Veneto, Padova, Italy.
Abstract
PURPOSE: To evaluate the clinical significance of indeterminate pulmonary nodules at diagnosis (defined as ≤ 4 pulmonary nodules < 5 mm or 1 nodule measuring ≥ 5 and < 10 mm) in patients with pediatric rhabdomyosarcoma (RMS). PATIENTS AND METHODS: We selected patients with supposed nonmetastatic RMS treated in large pediatric oncology centers in the United Kingdom, France, Italy, and the Netherlands, who were enrolled in the European Soft Tissue Sarcoma Study Group (E pSSG) RMS 2005 study. Patients included in the current study received a diagnosis between September 2005 and December 2013, and had chest computed tomography scans available for review that were done at time of diagnosis. Local radiologists were asked to review the chest computed tomography scans for the presence of pulmonary nodules and to record their findings on a standardized case report form. In the E pSSG RMS 2005 Study, patients with indeterminate pulmonary nodules were treated identically to patients without pulmonary nodules, enabling us to compare event-free survival and overall survival between groups by log-rank test. RESULTS: In total, 316 patients were included; 67 patients (21.2%) had indeterminate pulmonary nodules on imaging and 249 patients (78.8%) had no pulmonary nodules evident at diagnosis. Median follow-up for survivors (n = 258) was 75.1 months; respective 5-year event-free survival and overall survival rates (95% CI) were 77.0% (64.8% to 85.5%) and 82.0% (69.7% to 89.6%) for patients with indeterminate nodules and 73.2% (67.1% to 78.3%) and 80.8% (75.1% to 85.3%) for patients without nodules at diagnosis ( P = .68 and .76, respectively). CONCLUSION: Our study demonstrated that indeterminate pulmonary nodules at diagnosis do not affect outcome in patients with otherwise localized RMS. There is no need to biopsy or upstage patients with RMS who have indeterminate pulmonary nodules at diagnosis.
PURPOSE: To evaluate the clinical significance of indeterminate pulmonary nodules at diagnosis (defined as ≤ 4 pulmonary nodules < 5 mm or 1 nodule measuring ≥ 5 and < 10 mm) in patients with pediatric rhabdomyosarcoma (RMS). PATIENTS AND METHODS: We selected patients with supposed nonmetastatic RMS treated in large pediatric oncology centers in the United Kingdom, France, Italy, and the Netherlands, who were enrolled in the European Soft Tissue Sarcoma Study Group (E pSSG) RMS 2005 study. Patients included in the current study received a diagnosis between September 2005 and December 2013, and had chest computed tomography scans available for review that were done at time of diagnosis. Local radiologists were asked to review the chest computed tomography scans for the presence of pulmonary nodules and to record their findings on a standardized case report form. In the E pSSG RMS 2005 Study, patients with indeterminate pulmonary nodules were treated identically to patients without pulmonary nodules, enabling us to compare event-free survival and overall survival between groups by log-rank test. RESULTS: In total, 316 patients were included; 67 patients (21.2%) had indeterminate pulmonary nodules on imaging and 249 patients (78.8%) had no pulmonary nodules evident at diagnosis. Median follow-up for survivors (n = 258) was 75.1 months; respective 5-year event-free survival and overall survival rates (95% CI) were 77.0% (64.8% to 85.5%) and 82.0% (69.7% to 89.6%) for patients with indeterminate nodules and 73.2% (67.1% to 78.3%) and 80.8% (75.1% to 85.3%) for patients without nodules at diagnosis ( P = .68 and .76, respectively). CONCLUSION: Our study demonstrated that indeterminate pulmonary nodules at diagnosis do not affect outcome in patients with otherwise localized RMS. There is no need to biopsy or upstage patients with RMS who have indeterminate pulmonary nodules at diagnosis.
Authors: Jacquelyn N Crane; Wei Xue; Amira Qumseya; Zhengya Gao; Carola A S Arndt; Sarah S Donaldson; Douglas J Harrison; Douglas S Hawkins; Corinne M Linardic; Leo Mascarenhas; William H Meyer; David A Rodeberg; Erin R Rudzinski; Barry L Shulkin; David O Walterhouse; Rajkumar Venkatramani; Aaron R Weiss Journal: Pediatr Blood Cancer Date: 2022-03-06 Impact factor: 3.838
Authors: Roelof van Ewijk; Reineke A Schoot; Monika Sparber-Sauer; Simone A J Ter Horst; Nina Jehanno; Lise Borgwardt; Bart de Keizer; Johannes H M Merks; Alberto de Luca; Kieran McHugh; Thekla von Kalle; Jürgen F Schäfer; Rick R van Rijn Journal: Pediatr Radiol Date: 2021-06-17