Rhabdomyosarcoma of the head and neck

A retrospective review of all cases of rhabdomyosarcoma seen at UCLA was done. Survival prior to the advent of cyclic multidrug chemotherapy was compared to survival with this therapy. In the latter group, unlike other published series, survival was 150% better with gross total removal of disease as compared to biopsy only. All received at least 5000 rads. Fifteen percent presented with regional nodal metastases. However 75% of these also had intracranial extension and all died. An additional 19% developed late regional nodal metastases. Eighty percent of these also developed systemic metastases and all died. Survival in the absence of nodal disease was 41%. This is the first study to address the influence of regional nodal metastases, early and late on the outcome of treatment. In rhabdomyosarcoma of the head and neck, regional nodal metastases at any time implies a grave prognosis and more seriously adversely affects the progress than it does in squamous cell carcinoma in adults.