Brady AC, et al. - Researchers here examined the association of lymph node ratio [LNR: the number of positive lymph nodes (pLN) divided by total lymph nodes (LN) examined] with disease specific survival (DSS) in pediatric rhabdomyosarcoma (RMS). The SEER database yielded data from 188 patients (mean age at diagnosis: 8.8 ± 6 years) who underwent surgery for RMS between 1988 and 2013. These patients had a mean LNR of 0.13 ± 0.27. As per Cox regression analysis, independent determinants of worse DSS are LNR > 0.75, alveolar histology, age < 1 year, and distant disease. Findings support the superior independent prognostic value of LNR vs pLN status for DSS in pediatric RMS.