Do skeletal muscle bulk and density affect survival outcome in pediatric patients with rhabdomyosarcoma?

This retrospective study of 118 pediatric rhabdomyosarcoma patients aimed to determine the relationship between skeletal muscle characteristics on diagnostic CT scans and outcome. Univariate analysis revealed that older age and higher muscle bulk were associated with increased risk of events and mortality. While age remained a significant predictor in Cox regression for event-free survival, higher muscle density was associated with improved overall survival. Interestingly, a significant interaction between dichotomized muscle bulk and sex was observed for overall survival, suggesting higher bulk was associated with worse outcomes in males but potentially better outcomes in females. Our findings indirectly emphasize the importance of maintaining good nutrition and physical activity during chemotherapy to preserve muscle and improve outcomes, but further multicenter research is necessary to understand the complex interplay between body composition, sex and outcome in pediatric rhabdomyosarcoma.