Implications of Implementing Children's Oncology Group Risk Stratification to Patients With Rhabdomyosarcoma Treated on European Paediatric Soft Tissue Sarcoma Study Group Clinical Trial.

Rhabdomyosarcoma (RMS) is a type of cancer that primarily affects children, and determining the right treatment depends on assessing how aggressive the disease is. Two major groups, the European paediatric Soft Tissue Sarcoma Study Group (EpSSG) and the Children’s Oncology Group (COG), use different methods to assess this risk, leading to different treatment plans for similar patients.

This study reanalyzed data from nearly 2,000 RMS patients to see how they would be classified under each system and how this affects treatment recommendations, particularly chemotherapy. The researchers found that a large portion of patients were placed in different risk groups depending on the system used. For example, about one-third of patients classified as standard-risk by EpSSG were split into multiple risk groups by COG. Furthermore, two-thirds of all patients considered standard, high, or very high risk by EpSSG were classified as intermediate risk by COG. As a result, many patients would receive different levels of chemotherapy intensity under the two systems, with some receiving more intense treatment and others less.

This mismatch highlights the challenges in treating RMS and the importance of agreeing on a single global system to ensure patients with similar conditions receive comparable care and to make it easier to compare the results of clinical trials worldwide.