Rhabdomyosarcoma - Childhood: Stages and Groups

Approved by the Cancer.Net Editorial Board, 02/2014

ON THIS PAGE: You will learn about how doctors describe a cancer’s growth or spread. This is called the stage. The tumor’s Clinical Group describes whether it can be removed by surgery. To see other pages, use the menu on the side of your screen.

Doctors use both a grouping system and a staging system to describe rhabdomyosarcoma. Staging is a way of describing where the cancer is located, if or where it has spread, and whether it is affecting other parts of the body. Doctors use diagnostic tests to find out the cancer’s stage, so staging may not be complete until all of the tests are finished. Knowing the stage helps the doctor to decide what kind of treatment is best and can help predict a patient’s prognosis, which is the chance of recovery. There are different stage descriptions for different types of cancer.

Stage is determined by information called the TNM system. This system judges three factors: the tumor itself, the lymph nodes around the tumor, and if the tumor has spread to other parts of the body. The results are combined to determine the stage of cancer for each person.

TNM is an abbreviation for tumor (T), node (N), and metastasis (M): the “T” is used to describe the size and location of the tumor; the “N” stands for lymph nodes, the tiny bean-shaped organs that help fight infection; the “M” indicates whether the cancer has spread to other parts of the body.

The Clinical Group is based on whether a surgeon can remove the tumor. The Intergroup Rhabdomyosarcoma Studies (IRS) designed the following grouping and staging guidelines:

IRS Clinical Group

Group I: Describes a tumor that can be completely removed by surgery.

Group II: Describes a tumor that has been removed with surgery, but cancer cells remain at the edge of the tissue that surrounded the tumor, called a margin, and/or cancer cells are in the regional lymph nodes, which are lymph nodes near the site of the tumor.

Group III: Describes a local tumor, which is a tumor that has not spread outside of the area where it started, that cannot be removed by surgery.

Group IV: Distant metastases, which means that cancer that has spread to other parts of the body, are present at the time of diagnosis.

IRS-modified TNM stage

Stage 1: Describes a small local tumor in the orbit (the area near the eye); head and neck area, except for parameningeal sites; or a genitourinary tract tumor, except for a tumor in the bladder or prostate.

Stage 2: Describes a small local tumor in any part of the body not in Stage 1. The tumor is smaller than 5 centimeters (cm), and there is no spread to regional lymph nodes.

Stage 3: Describes a local tumor in any part of the body not included in Stage 1 that is larger than 5 cm in diameter and/or has spread to regional lymph nodes.

Stage 4: Distant metastases are present at diagnosis. The primary tumor can be of any size or location.

Recurrent: Recurrent cancer is cancer that has come back after treatment. If there is a recurrence, the cancer may need to be staged again (called re-staging) using the system above.

Source: Soft Tissue Sarcoma Committee of the Children's Oncology Group (COG).

Information about the cancer’s stage will help the doctor recommend a treatment plan.  The next section helps explain the treatment options for this type of cancer. Use the menu on the side of your screen to select Treatment Options, or you can select another section, to continue reading this guide.