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 ( χ ² = 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.