However in "A Report From an International Consortium", the authors analyzed patient data from the Childrens Oncology Group (COG) and European paediatric Soft tissue sarcoma Study Group (EpSSG), hoping to identify and analyze any relationship between clinical outcomes and genetic mutations. The study comprised of 641 patients with sufficient data to analyze.Contrary to previous research, the findings of this study suggest that having RAS isoform mutations did not necessarily equate to a poor development of the disease. However, a pattern was found between the RAS isoform mutation seen and ones stage in life; HRAS isoform in infants, KRAS isoform in toddlers, and NRAS isoform in adolescence. This clinical study also found similar results as previous studies with the correlation of TP53 mutations and clinical outcome. TP53 mutations tended to result in a worsening development and clinical outcome of the disease. Although MYOD1 mutations make up a small percentage of ERMS, these mutations have been seen to have a negative prognosis and more studies should be conducted to understand how to treat the clinical condition of this specific mutation. Tumor Location
Tumor location plays an important role as RMS located in the parameningeal area, retroperitonium, pelvic, vulva, uterus, vagina, or trunk area genereally have poor prognosis. The anatomical position of parameningeal RMS makes it difficult to completely resect the entire tumor via surgery and may lead to tumor recurrence. Additionally, imaging that shows a tumor greater than 5 cm, presence of metastases, or positive lymph node status can indicate poor prognosis.
As a result, the World Health Organization currently takes into account both molecular genetics and morphology to classify rhabdomyosarcoma into the embryonal, alveolar, spindle cell/sclerosing, and pleomorphic subtypes.When examining Embroynal Rhabdomyosarcoma tumors vs. Alveolar Rhabdomyosarcoma tumors, a 2013 study had discovered that there were more rates of mutation in ERMS tumors. The study had use whole genome sequencing to sequence the DNA from 16 RMS tumors and found that RAS pathway mutations tend to be more associated with intermediate and high risk embryonal Rhabdomyosarcoma. Additionally, Embryonal Rhabdomyosarcoma tends to be more common in males versus females, with an occurrence of 1.4:1. Histology
Embryonal rhabdomyosarcoma has been informally classified as a "small round blue cell tumor" because of the characteristic microscopic appearance of its cells after histological staining with hematoxylin and eosin. Histologically, embryonal rhabdomyosarcoma commonly presents as alternating loose and dense patches of cells, including round cell and spindle cell components. The heterogenous structure resembles striated muscle at various embryonal developmental stages. Location
Embryonal rhabdomyosarcoma can develop in soft tissues throughout the body, however, it is commonly found in the "head and neck area or in the genital or urinary organs"  The botryoid variant of ERMS occurs in mucosal-lined organs such as the common bile duct, bladder, and vagina. The etymology for this variant name comes from "grape clusters", referring to the gross appearance of grape-like masses. Epidemiology of RMS
RMS has a higher incidence of affecting males compared to females.