National assessment of lymph node status indicators & predictors in pediatric head and neck rhabdomyosarcomas in the US

David J Fei-Zhang; Asher C Park; Joseph M Berry; Rebecca S Arch; Daniel C Chelius; Anthony M Sheyn; Jeffrey C Rastatter

doi:10.1016/j.ijporl.2022.111419

National assessment of lymph node status indicators & predictors in pediatric head and neck rhabdomyosarcomas in the US

Int J Pediatr Otorhinolaryngol. 2023 Jan:164:111419. doi: 10.1016/j.ijporl.2022.111419. Epub 2022 Dec 12.

Authors

David J Fei-Zhang¹, Asher C Park², Joseph M Berry³, Rebecca S Arch⁴, Daniel C Chelius⁵, Anthony M Sheyn³, Jeffrey C Rastatter⁶

Affiliations

¹ Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL, 60611, USA. Electronic address: david.fei-zhang@northwestern.edu.
² Northwestern University Feinberg School of Medicine, 420 E Superior St, Chicago, IL, 60611, USA.
³ Department of Pediatric Otolaryngology, Le Bonheur Children's Hospital, Memphis, TN, USA; Department of Otolaryngology-Head and Neck Surgery, University of Tennessee Health Science Center, 910 Madison Avenue, Memphis, TN, 38163-2242, USA; Department of Pediatric Otolaryngology, St. Jude Children's Research Hospital, Memphis, TN, USA.
⁴ Department of Otolaryngology-Head and Neck Surgery, The Ohio State University Wexner Medical Center, 410 W 10th Ave, Columbus, OH, 43210, USA.
⁵ Department of Otolaryngology-Head and Neck Surgery, Pediatric Thyroid Tumor Program and Pediatric Head and Neck Tumor Program, Baylor College of Medicine, Texas Children's Hospital, 6701 Fannin Street, Houston, TX, 77030, USA.
⁶ Department of Otolaryngology-Head and Neck Surgery, Northwestern University Feinberg School of Medicine, 675 N Saint Clair, Chicago, IL, 60611, USA; Division of Pediatric Otolaryngology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 East Chicago Avenue, Chicago, IL, 60611, USA.

PMID: 36525697
DOI: 10.1016/j.ijporl.2022.111419

Abstract

Objectives: Assessing the prognostic utility of lymph node status in pediatric rhabdomyosarcoma (RMS) patients and identifying demographic and clinical predictors of positive lymph node status among pediatric rhabdomyosarcoma patients.

Study design: Retrospective cohort study of head and neck RMS in patients with and without positive lymph node metastasis.

Methods: National Cancer Database (NCDB) was queried for patients of young (0-11 years) and adolescent (12-21 years) ages with head and neck RMS and confirmed positive or negative lymph node metastasis status. Descriptive analyses, Kaplan-Meier survival analyses, and multivariate logistic regressions were performed on extracted demographic and clinical characteristics.

Results: Among 272 head and neck RMS patients, 146 (54%) were found to have positive lymph node metastasis. Alveolar RMS (n = 147, 54%) followed by embryonal RMS (n = 74, 27%) were the most represented histology types. Positive lymph node metastasis conferred significantly decreased survivability (p < 0.001) with a median survival period of 36.42 months compared to negative lymph node metastasis with a period of 53.47 months. Older age showed markedly increased odds (OR-2.02; 95%CI 1.22-3.38) of having lymph node metastasis when controlling for sex, race, insurance status, and Charlson-Comorbidity score. Alveolar histologies showed markedly increased odds of having lymph node metastasis (OR-3.21; 95%CI 1.96-5.31); embryonal histologies showed markedly decreased odds of having lymph node metastasis (OR-0.32; 95%CI 0.18-0.56) CONCLUSIONS: This study highlights the significant prognostic value of lymph node status among pediatric head and neck rhabdomyosarcoma patients while showcasing crucial demographic and pathological predictors of lymph node metastasis in said patients. Use of lymph node status in pediatric head and neck rhabdomyosarcoma will present future steps towards improving its clinical course.

Keywords: Lymph node metastasis; NCDB; Pediatric; Rhabdomyosarcoma.

MeSH terms

Adolescent
Child
Head and Neck Neoplasms* / pathology
Head and Neck Neoplasms* / therapy
Humans
Lymph Nodes / pathology
Lymphatic Metastasis / pathology
Prognosis
Retrospective Studies
Rhabdomyosarcoma* / therapy
Rhabdomyosarcoma, Embryonal*