ARMS lacking the PAX3/7-FOXO1 fusion protein are molecularly and clinically indistinguishable from ERMS, together constitute the fusion-negative (FN)-RMS group (1, 5, 11), and have a better outcome, whereas FP-RMS is associated with significantly worse outcomes which led to current prospective clinical studies using fusion status rather than histology as risk stratifier (2, 12, 13). This evidence concerns the gene FOXO1 and alveolar rhabdomyosarcoma.