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Childhood Rhabdomyosarcoma Treatment

Stages of Childhood Rhabdomyosarcoma

After childhood rhabdomyosarcoma has been diagnosed, treatment is based on the stage of the cancer and whether cancer remains after surgery to remove the tumor.

The process used to find out if cancer has spread within the muscle or to other parts of the body is called staging. It is important to know the stage in order to plan treatment. The doctor will use results of the diagnostic tests to help determine the stage of the disease.

Treatment for childhood rhabdomyosarcoma is based on the stage and the amount of cancer that remains after surgery to remove the tumor. The pathologist will use a microscope to check the tissues, including lymph nodes, removed during surgery, and the edges of the areas where the cancer was removed. This is done to see if all the cancer cells were taken out during the surgery.

There are three ways that cancer spreads in the body.

The three ways that cancer spreads in the body are:

When cancer cells break away from the primary (original) tumor and travel through the lymph or blood to other places in the body, another (secondary) tumor may form. This process is called metastasis. The secondary (metastatic) tumor is the same type of cancer as the primary tumor. For example, if breast cancer spreads to the bones, the cancer cells in the bones are actually breast cancer cells. The disease is metastatic breast cancer, not bone cancer.

Staging of childhood rhabdomyosarcoma is done in three related steps.

Childhood rhabdomyosarcoma is staged by using three different ways to describe the cancer:

The staging system is based on the size of the tumor, where it is in the body, and whether it has spread to other parts of the body:

Stage 1

In stage 1, cancer is any size, has not spread to lymph nodes, and is found in only one of the following "favorable" sites:

Rhabdomyosarcoma that occurs in a "favorable" site has a better prognosis. If the site where cancer occurs is not one of the favorable sites listed above, it is said to be an "unfavorable" site.


Pea, peanut, walnut, and lime show tumor sizes.
Pea, peanut, walnut, and lime show tumor sizes.

Stage 2

In stage 2, cancer is found in any one area not included in stage 1. The tumor is 5 centimeters or smaller and has not spread to lymph nodes.

Stage 3

In stage 3, cancer is found in any one area not included in stage 1 and one of the following is true:

Stage 4

In stage 4, the tumor may be any size and cancer may have spread to nearby lymph nodes. Cancer has also spread to distant parts of the body such as the lung, bone marrow, or bone.

The grouping system is based on whether the cancer has spread and how much cancer remains after surgery to remove the tumor:

Group I

Cancer was found only in the place where it started and it was completely removed by surgery. Tissue was taken from the edges of where the tumor was removed. The tissue was checked under a microscope by a pathologist and no cancer cells were seen.

Group II

Group II is divided into groups IIA, IIB, and IIC.

Group III

Cancer was partly removed by surgery and there are cancer cells (a lump or mass) remaining that can be seen by x-ray or other imaging test. Cancer has not spread to distant parts of the body.

Group IV

Cancer had spread to distant parts of the body at the time of diagnosis.

The risk group is based on the staging system and the grouping system and is used to plan treatment.

The risk group describes the chance that rhabdomyosarcoma will recur (come back). The following risk groups are used:

Low-risk childhood rhabdomyosarcoma

Low-risk childhood rhabdomyosarcoma is one of the following:

Intermediate-risk childhood rhabdomyosarcoma

Intermediate-risk childhood rhabdomyosarcoma is one of the following:

High-risk childhood rhabdomyosarcoma

High-risk childhood rhabdomyosarcoma may be the embryonal type or the alveolar type. It may have spread to nearby lymph nodes and has spread to one or more distant parts of the body.