الفهرس 
Prevalence and clinical significance of anaplasia and p53 expression in childhood rhabdomyosarcoma, National Cancer Institute, Egypt
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Abstract
Background: Anaplastic features in childhood rhabdomyosarcoma (RMS) are rare. Anaplasia has been proposed to relate to poor clinical outcomes, but it remains vague and has not been included in the International Classification of Rhabdomyosarcoma (ICR). p53 expression has been correlated to anaplastic features in a few studies.
Aim:The study aimed to determine the frequency of both anaplastic features and nuclear p53 expression at presentation in childhood RMS and their relationship to clinicopathologic variables and clinical outcomes.
Patients and methods:Anaplasia and p53 nuclear expression status were assessed in 120 and 67 pediatric rhabdomyosarcoma patients, respectively who were registered at the National Cancer Institute (NCI), Cairo University, Egypt, during the period from January 2010 to December 2018. All pathological materials were reviewed blindly for the presence of anaplasia.Tumor sections were counted as positive if nuclear staining was clearly observed in more than 5% of tumor cells.
Results: Anaplasia was diagnosed in 32 patients (26.7%) with an equal ratio of diffuse to focal type of anaplasia. The 5-year overall survival rates for patients with and without anaplasia were 57.5% and 59.9%, respectively, and the 5-year event-free survival rates were 52.1%, 56.8%, respectively without statistically significant difference.
Among 67 patients assessed for tumor p53 nuclear staining expression, there were 24 patients (35.8%) with positive nuclear p53 staining. The 5-year overall survival rates for patients with and without p53 nuclear expression were 64.2% and 65%, respectively, and the 5-year event-free survival rates were 57.1% and 60.5%, respectively without statistically significant difference. There was a statistically significant association between the presence of anaplasia and p53 nuclear staining detection (p = 0.014), but with no significant impact on the outcome