Clinical group and modified TNM stage for rhabdomyosarcoma: A review from the Children's Oncology Group

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

doi:10.1002/pbc.29644

Clinical group and modified TNM stage for rhabdomyosarcoma: A review from the Children's Oncology Group

Pediatr Blood Cancer. 2022 Jun;69(6):e29644. doi: 10.1002/pbc.29644. Epub 2022 Mar 6.

Authors

Jacquelyn N Crane¹, Wei Xue², Amira Qumseya², Zhengya Gao², Carola A S Arndt³, Sarah S Donaldson⁴, Douglas J Harrison⁵, Douglas S Hawkins⁶, Corinne M Linardic⁷, Leo Mascarenhas⁸, William H Meyer⁹, David A Rodeberg¹⁰, Erin R Rudzinski¹¹, Barry L Shulkin¹², David O Walterhouse¹³, Rajkumar Venkatramani¹⁴, Aaron R Weiss¹⁵

Affiliations

¹ Department of Pediatrics, Stanford University, Stanford, California, USA.
² Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, Florida, USA.
³ Department of Pediatric and Adolescent Medicine, Mayo Clinic and Foundation, Rochester, Minnesota, USA.
⁴ Department of Radiation Oncology, Stanford University, Stanford, California, USA.
⁵ Department of Pediatrics, Texas Children's Cancer Center, Baylor College of Medicine, Houston, Texas, USA.
⁶ Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, Washington, USA.
⁷ Department of Pediatrics, Duke University School of Medicine, Durham, North Carolina, USA.
⁸ Children's Hospital Los Angeles and University of Southern California Keck School of Medicine, Los Angeles, California, USA.
⁹ University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA.
¹⁰ Division of Pediatric Surgery, Department of Surgery, East Carolina University, Greenville, North Carolina, USA.
¹¹ Department of Laboratories, Seattle Children's Hospital, Seattle, Washington, USA.
¹² Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, Tennessee, USA.
¹³ Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
¹⁴ Department of Pediatrics, Baylor College of Medicine, Houston, Texas, USA.
¹⁵ Department of Pediatrics, Maine Medical Center, Portland, Maine, USA.

Abstract

The Children's Oncology Group (COG) uses Clinical Group (CG) and modified Tumor Node Metastasis (TNM) stage to classify rhabdomyosarcoma (RMS). CG is based on surgicopathologic findings and is determined after the completion of initial surgical procedure(s) but prior to chemotherapy and/or radiation therapy. The modified TNM stage is based on clinical and radiographic findings and is assigned prior to any treatment. These systems have evolved over several decades. We review the history, evolution, and rationale behind the current CG and modified TNM classification systems used by COG for RMS. Data from the seven most recently completed and reported frontline COG trials (D9602, D9802, D9803, ARST0331, ARST0431, ARST0531, ARST08P1) were analyzed, and confirm that CG and modified TNM stage remain relevant and useful for predicting prognosis in RMS. We propose updates based on recent data and discuss factors warranting future study to further optimize these classification systems.

Keywords: clinical group; rhabdomyosarcoma; stage.

Publication types

Review
Research Support, N.I.H., Extramural
Research Support, Non-U.S. Gov't

MeSH terms

Child
Humans
Neoplasms, Second Primary*
Prognosis
Rhabdomyosarcoma* / drug therapy
Rhabdomyosarcoma, Embryonal* / pathology

Abstract

Publication types

MeSH terms

Grants and funding