People that have more distant tumors — tumors that have spread to distant parts away from the primary site — have higher mortality rate when compared to people with only localized tumors. Age of Diagnosis
In a 2020 case study of 464 adolescents aged 0–19 years diagnosed with rhabdomyosarcoma between 1988 to 2016, children who were diagnosed between ages 5–9 years had the most promising prognosis. In contrast, infants less than 1 years old had the worst outcome, which may be associated to the lower doses of chemotherapy and radiotherapy administered and naive immune system. Treatment
Treatment for embryonal rhabdomyosarcoma involves the use of combination therapy consisting of chemotherapy, surgery, and/or radiation therapy. In order to create an optimal treatment plan for the individual, therapy is often based upon risk stratigication (low, intermediate, or high risk) based off of individuals disease stage, size of tumor, progression of disease, surgery resection, age at diagnosis, and site of tumor. In the US, a combination of Vincristine, Actinomycin D, and cyclophosphamide are often the chemotherapeutics used to treat rhabdomyosarcoma. In contrast, the regimen in Europe utilizes Vincristine, Actinomycin D, and ifosfamide. When the US and European regimen were studied side by side, the two regimens were comparable in terms of efficacy outcomes. Radiation therapy continues to be an integral component of rhabdomyosarcoma treatment, however, the long-term safety and treatment related complications remain a concern.
In either case, "fusion-negative" alveolar rhabdomyosarcoma have similar clinical presentation and outcome as embryonal rhabdomyosarcoma, thus risk stratification, prognosis, and treatment intensity of rhabdomyosarcoma are now determined by fusion-status instead of histological classification. Imaging
After a physical exam, formal diagnosis of RMS in adult patients requires a computed tomography (CT) scan, which can assess the areas affected and to delineate the tumor. In children, physicians may opt for magnetic resonance imaging (MRI) to limit radiation exposure in younger populations. In the majority of individuals diagnosed with rhabdomyosarcoma, more than half are diagnosed before the age of 10. Prognosis
The prognosis for rhabdomyosarcoma has improved greatly in recent decades, with over 70% of people surviving for five years after diagnosis. The combined use of radiotherapy and surgery has significantly reduced the mortality rates compared to patients who did not undergo any radiotherpay or chemotherapy treatments. Embryonal rhabdomyosarcoma is generally associated with better prognosis than alveolar rhabdomyosarcoma, with a 5-year survival prognosis of 82% and 53%, respectively. This may be due to the more aggressive and metastatic nature of ARMS that can be attributed to its PAX3–FOXO1 or PAX7–FOXO1 gene fusions. Nevertheless, some embryonal rhabdomyosarcoma patients with a rare Leu122Arg mutation in MYOD1 gene have a very poor outcome. In two different studies, none of the subjects with the MYOD1 mutation survived. Tumors due to this mutation commonly manifest in the head and neck area, causing the mutated protein to behave like an oncogene.There have not been many studies linking the genetic profile and clinical outcome of ERMS.