Trial reportCancer2021
Benefit of delayed primary excision in rhabdomyosarcoma: A report from the Children's Oncology Group.
Trial report in Cancer, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it, 40 citations in OpenAlex.
- Biliary Rhabdomyosarcoma in Pediatric Patients: A Systematic Review and Meta-Analysis of Individual Patient Data.Frontiers in oncology · 2021Pooled it
- Radiation Therapy Dose Escalation Failed to Improve Local Control for Intermediate-Risk Rhabdomyosarcoma on ARST1431: A Report From the Children's Oncology Group.International journal of radiation oncology, biology, physics · 2025Trial
- Pediatric Rhabdomyosarcoma in the Head and Neck: An Overview.Journal of neurological surgery reports · 2026Article
- Article
- Intermediate Risk Rhabdomyosarcoma in Very Young Children (Less Than or Equal to 24 Months) Treated on the Prior Children's Oncology Group Protocol ARST1431.Pediatric blood & cancer · 2026Article
- Genitourinary rhabdomyosarcoma in a child with urinary incontinence as the initial symptom: A case report and literature review.Urology case reports · 2025Article
- Extremity rhabdomyosarcoma in children, adolescents and young adults: A report from Children's Oncology Group trials.Cancer · 2025Article
- Nephrostomy tubes for management of a bladder occupying embryonal rhabdomyosarcoma in a 2-year-old: A case report and review of the literature.Urology case reports · 2025Article
- Outcomes for patients with perineal and perianal rhabdomyosarcoma: A report from the Children's Oncology Group Soft Tissue Sarcoma Committee.Pediatric blood & cancer · 2024Article
- Article
- Rhabdomyosarcoma of the biliary tract in a child: a case report.Frontiers in pediatrics · 2024Article
- Current topics and management of head and neck sarcomas.Japanese journal of clinical oncology · 2023Review
- Management and outcomes of chest wall rhabdomyosarcoma: A report from the Children's Oncology Group Soft Tissue Sarcoma Committee.Pediatric blood & cancer · 2023Article
- Review
- Pattern of relapse in pediatric localized extremity rhabdomyosarcomas correlated with locoregional therapies administered.Strahlentherapie und Onkologie : Organ der Deutschen Rontgengesellschaft ... [et al] · 2021Article
- Review
- Letter to the Editor: Local Treatment of Children Suffering From Parameningeal Rhabdomyosarcoma - A Retrospective Single-Center Study From China.Cancer control : journal of the Moffitt Cancer CenterArticle
Corrections and comments
- Commented on by
- Erratum issued
Authors and funding
12 authors at 11 institutions in 1 country.
Funding
Abstract
backgroundMost children with intermediate-risk rhabdomyosarcoma (RMS) have gross disease (group III) at the initiation of chemotherapy. Delayed primary excision (DPE) after induction chemotherapy allows for a reduction in adjuvant radiation dose, but with the risk of potential surgical morbidity. The objectives of this study were to compare outcomes in children with group III RMS who did and did not undergo DPE and to assess surgical morbidity.
methodsThe study included 369 patients who had clinical group III RMS at sites amenable to DPE from intermediate-risk Children's Oncology Group studies D9803 (encouraged DPE) and ARST0531 (discouraged DPE).
resultsThe primary tumor site was bladder/prostate (136 patients; 37%), extremity (97 patients; 26%), trunk (24 patients; 7%), retroperitoneum (91 patients; 25%), or intrathoracic/perineum/perianal (21 patients; 6%). In total, 112 patients (53.9%) underwent DPE in D9803, and 26 patients (16.2%) underwent DPE in ARST0531 (P < .001), with loss of vital organ or function in 30 of 138 patients (22%). DPE allowed for a reduced radiation dose in 110 of 135 patients (81%; 51% were reduced to 36 Gy, and 30% were reduced to 42 Gy). Patients who underwent DPE had improved unadjusted overall survival (P = .013). In adjusted regression analysis, the risk of death (hazard ratio, 0.71; 95% CI 0.43-1.16) was similar for patients who did and did not undergo DPE and was improved for the subset of patients who had tumors of the trunk and retroperitoneum (hazard ratio, 0.44; 95% CI, 0.20-0.97).
conclusionsChildren with group III RMS have equivalent or improved outcomes with DPE and can receive a decreased radiation dose for definitive local control. The choice of local control modality should weigh the potential morbidity of surgery versus that of higher dose irradiation.
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