Radical surgery for head and neck rhabdomyosarcoma failed primary chemotherapy

Objective: The aim of the study was to explore an optimal surgery way for head and neck rhabdomyosarcoma (HNRMS) children who have failed primary chemotherapy. Methods: A total of 51 HNRMS children who have failed primary chemotherapy were retrospectively analyzed from April 2005 to May 2017. Surgery was performed in 2 ways, widely radical resection (22 patients) and conservative resection (29 patients). Multivariate analysis was performed to identify the various variables related to overall survival (OS). Results: The estimated 5-year OS was 53%. Embryonic RMS enjoyed a favorable outcome than those nonembryonic RMS (P=0.03). Head and neck rhabdomyosarcoma children who received partial remission (PR) after primary chemotherapy enjoyed a better outcome than those only achieved stable disease (SD) (P=0.006). A total of 22 children accepted widely radical resection, whereas 29 patients got conservative resection. Interestingly, the 2 groups did not have a statistical significance (P=0.86). However, the latter group children have conserved more important organs, such as eyeball, facial nerves, and enough mandible or maxilla bones, and have enjoyed a better life quality. Conclusion: Primary chemotherapy is most important for HNRMS children, which influences the prognosis of HNRMS widely. Conservative resection is an optimal surgery way for HNRMS, bringing a better life quality for these children.