A rational clinical staging system for childhood rhabdomyosarcoma.

There is a need for a rational and useful staging system for childhood rhabdomyosarcoma that predicts prognosis based on the biology and natural history of the disease. Important factors to consider are age, histology, tumor volume, extent of invasion, and lymphatic involvement. A clinical staging system based on a classical tumor/node/metastasis status, and which accounts for natural history as a function of site of primary, local invasion, and lymphatic or hematogenous metastases is presented. This staging system eliminates the requirement that stage is assigned following an initial therapeutic strategy and removing the implication that prognosis is determined by that strategy.