Of the approximately 400 children and adolescents diagnosed each year in the United States with rhabdomyosarcoma, between one in five and one in six will be considered high-risk patients by virtue of the presence of one or more sites of distant metastatic
disease, most commonly involving lymph nodes, bones, bone marrow, and the lungs. These patients tend to be disproportionately older, of male sex, and have alveolar histology, and most present with bulky tumors (> 5 cm).

Leonard H. Wexler, Memorial Sloan Kettering Cancer Center, New York, NY

Journal of Clinical Oncology, Vol 34, No 2 (January 10), 2016: pp 105-106