Evaluation of Prognostic Factors in Adult Sinonasal Rhabdomyosarcoma With Consideration of Resection Status

OBJECTIVE: To evaluate R0 resection's prognostic significance and its association with induction chemotherapy (ICT) response in adult sinonasal rhabdomyosarcoma (SNRMS). STUDY DESIGN: Retrospective study. SETTING: Beijing Tongren Hospital and the National Cancer Hospital. METHODS: Fifty-one patients who met the inclusion criteria were identified through chart review. Patients were divided into 3 groups: a nonsurgical group and 2 surgical groups, 1 with a R0 resection and one with a positive margin. Overall survival (OS) and progression-free survival (PFS) were calculated using the Kaplan-Meier analysis. The Log-rank test and Cox regression analysis were performed to evaluate prognostic factors. The chi-square test was used to analyze associations. RESULTS: No differences in characteristics were observed among the groups. Patients with R0 resection had significantly higher OS and PFS than those with positive margins or nonsurgical (OS: P = .001, P = .016, respectively; PFS: P < .001, P = .005, respectively). There was no significant difference in OS or PFS between positive margins and nonsurgical group (P = .163, P = .059, respectively). Multivariate analysis revealed that R0 resection was an independent risk factor for OS (HR = 0.224, 95% CI: 0.079-0.639, P = .005). The R0 resection rate was significantly higher in the positive ICT response group than in the negative response group and the non-ICT group (χ² = 7.119, df = 2, P = .028). CONCLUSION: The overall treatment strategy for adult SNRMS should focus on achieving local tumor control through comprehensive, multidisciplinary treatment to achieve R0 resection.