Medical Oncology

, 36:59 | Cite as

Rhabdomyosarcoma in adults: analysis of treatment modalities in a prospective single-center series

  • Luca BergamaschiEmail author
  • Rossella Bertulli
  • Michela Casanova
  • Salvatore Provenzano
  • Stefano Chiaravalli
  • Patrizia Gasparini
  • Paola Collini
  • Claudia Sangalli
  • Lorenza Gandola
  • Barbara Diletto
  • Carlo Morosi
  • Marco Fiore
  • Maura Massimino
  • Andrea Ferrari
Original Paper


Rhabdomyosarcoma (RMS) is rare in adults and it is generally characterized by poor outcome. In a previous retrospective study, we demonstrated a better prognosis in adults treated with multimodality approach resembling pediatric protocols. Thereafter, we developed specific recommendations based on the principles adopted in pediatric oncology. The present analysis reports the results in a subsequent prospective series. The study included 95 consecutive patients (age 18–77 years) treated from 2002 to 2015 for embryonal and alveolar RMS. As in the previous series, patients were stratified by the appropriateness of their treatment according to therapeutic guidelines for childhood RMS. The 5-year event-free survival (EFS) and overall survival (OS) rates were 33.6% and 40.3%, respectively. The 5-year EFS was 40.8% for patients with the highest treatment score, and 15% for those with lower score, while OS was 44.4% and 24.5%, respectively. The developing of specific recommendations enabled an increase in the number of patients treated with intensive multimodal treatment resembling pediatric strategy (69.7% vs. 39.1% in the retrospective series). This study reinforced the idea that adherence to the principles of pediatric protocols, improves adult RMS outcomes. However, treating adults with pediatric-type strategy is not enough to achieve the results obtained in children. Issues in compliance and a more aggressive biology of adult RMS might have a role in the different outcome according to age. Improving the collaboration between pediatric and adult oncologists in promoting specific clinical and biological research is crucial to improve the outcome for this patient population.


Rhabdomyosarcoma Adults Multimodal treatment Treatment score Childhood tumors in adults Soft tissue sarcoma 



This research did not receive any specific grant from funding agencies in the public, commercial or not-for-profit sectors.

Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest to disclose.

Ethical approval

This study was performed in accordance with the Declaration of Helsinki. The project was approved by the Research Ethical Committee of the Fondazione IRCCS Istituto Nazionale Tumori, Milan, Italy (code 150053 of the Italian National Observatory on Clinical Trials). All the patients signed a written informed consent for their involvement in the project and for the use of their personal data.


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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Luca Bergamaschi
    • 1
    Email author
  • Rossella Bertulli
    • 2
  • Michela Casanova
    • 1
  • Salvatore Provenzano
    • 2
  • Stefano Chiaravalli
    • 1
  • Patrizia Gasparini
    • 3
  • Paola Collini
    • 4
  • Claudia Sangalli
    • 5
  • Lorenza Gandola
    • 6
  • Barbara Diletto
    • 6
  • Carlo Morosi
    • 7
  • Marco Fiore
    • 8
  • Maura Massimino
    • 1
  • Andrea Ferrari
    • 1
  1. 1.Pediatric Oncology Unit, Medical Oncology and Hematology DepartmentFondazione IRCCS Istituto Nazionale TumoriMilanItaly
  2. 2.Adult Mesenchymal Tumor and Rare Cancer Medical Oncology Unit, Medical Oncology and Hematology DepartmentFondazione IRCCS Istituto Nazionale TumoriMilanItaly
  3. 3.Tumor Genomics UnitFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  4. 4.Histopathology And Pediatric Pathology Unit, Diagnostic Pathology and Laboratory Medicine Department, Soft Tissue And Bone PathologyFondazione IRCCS Istituto Nazionale dei TumoriMilanItaly
  5. 5.Department of RadiotherapyFondazione IRCCS Istituto Nazionale TumoriMilanItaly
  6. 6.Pediatric Radiotherapy Unit, Department of RadiotherapyFondazione IRCCS Istituto Nazionale TumoriMilanItaly
  7. 7.Department of RadiologyFondazione IRCCS Istituto Nazionale TumoriMilanItaly
  8. 8.Department of SurgeryFondazione IRCCS Istituto Nazionale TumoriMilanItaly

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