Organ‐preserving management of rhabdomyosarcoma of the prostate and bladder in children

Silván, A.M. Álvarez; Gordillo, María Dolores Gordillo; Lopez, Ana Millan; Cuevas, G. Pineda; Gutierrez, José Alfaro; Iriondo, Juan María Loizaga; Cantón, Juan Antonio Garcia; Martínez, Adolfo Carrasco; Quesada, María Luisa Anguita; Arceaga, Miguel Angel Maillo; Vallés, María del Carmen García

doi:10.1002/(sici)1096-911x(199712)29:6<573::aid-mpo10>3.3.co;2-5

Cited by 4 publications

(7 citation statements)

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“…No information on bladder function was given. Silvan et al [26] reported from their series of organ-sparing management and adjuvant radiotherapy that acute and recurrent haemorrhagic cystitis in nine of 10 children were the most common complication. In the Mansoura series [23], none of the three patients undergoing partial cystectomy after chemotherapy and external radiation was felt to have adequate bladder capacity, so that augmentation cystoplasty was required in all.…”

Section: Discussionmentioning

confidence: 99%

Rhabdomyosarcoma of the bladder, prostate or vagina: the role of surgery

et al. 2003

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Rhabdomyosarcoma of pelvic organs is not common enough for many people to develop large series. However, the authors from Mainz retrospectively analysed 107 children with this condition, and suggest that primary chemotherapy followed by radical surgery yields excellent cure rates.OBJECTIVETo retrospectively analyse the outcome of children with rhabdomyosarcoma (RMS) of the bladder, prostate or vagina who were treated with chemotherapy, with or without radical surgery or additional radiotherapy, at our institution since 1968.PATIENTS AND METHODSFrom a total of 107 children with RMS seen between 1968 and December 2001, 22 (mean age 5.9, range 0.5–18) had RMS of bladder/prostate or vagina. Twenty of the patients received primary polychemotherapy (vincristine, actinomycin D, cyclophosphamide, adriamycin, and more recently including etoposide and ifosfamide), two had primary surgery and seven had additional radiotherapy. Fourteen patients had radical cystoprostatectomy, with continent cutaneous urinary diversion with an ileocaecal pouch in seven, in one each a transverse colonic pouch, orthotopic ileocaecal bladder substitution, a rectal reservoir and rectosigmoid pouch and a colonic conduit diversion in two patients.RESULTSAfter a mean (range) follow‐up of 8.6 (1.0–26) years, 17 patients had no evidence of disease. Five patients presenting initially with advanced tumour stages died from progressive RMS. Two patients with a continent urinary diversion required ureteric reimplantation for stenosis. In two patients severe bladder contraction after radiotherapy required bladder augmentation.CONCLUSIONPrimary chemotherapy followed by radical surgery of RMS of the prostate and/or bladder allows complete tumour resection in most cases, and yields excellent cure rates.

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Section: Discussionmentioning

confidence: 99%

Rhabdomyosarcoma of the bladder, prostate or vagina: the role of surgery

et al. 2003

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“…All used some sort of combination CTX, usually VAC, and surgery with or without RT on most of their populations. 15,19,[47][48][49][50][51][52][53][54][55][56][57] Two of the studies 49,55 were primary surgery studies, while the remainder were primary CTX studies. Some of the primary CTX studies would base subsequent use of either surgery and/or RT on the initial CTX response.…”

Section: Single-institutional Trialsmentioning

confidence: 99%

Treatment modalities of bladder/prostate rhabdomyosarcoma: a review

Ashlock¹,

Johnstone

2003

Prostate Cancer Prostatic Dis

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Treatment outcomes of bladder/prostate rhabdomyosarcoma (RMS) in multi-and single-institutional trials are reviewed. Remarkable strides have occurred in the treatment of this disease. Decreasing duration of chemotherapy, less cumulative doses of radiation therapy, and improving survival have been documented. A focus on bladder preservation has not adversely affected survival in most studies. Even if organ preservation is not possible, improvements in urinary diversion surgical technique still offer improved quality of life. The IRS III was a pivotal study in improving survival and quality of life. We recommend protocol enrollment whenever available. We also emphasize the use of magnetic resonance imaging and second look surgery.

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“…Rarely is amputation required for tumor excision.The importance of complete excision cannot be overstated because survival is 70-91% with microscopic residual disease or complete excision and only 23-50% with metastatic or gross residual disease. 62,67 Also, the survival rate for incomplete resection is no better than incisional biopsy alone. 57 Approximately half of children who die from these tumors have local recurrences; 64 therefore, if residual tumor is known or suspected after initial resection, a PRE should be done to excise the tumor before other treatment is begun.…”

Section: Extremitymentioning

confidence: 99%

“…66,67,36 After several months of medical therapy, extent of disease should be reevaluated. If complete resection is possible surgeons should proceed to operation.…”

Section: Extremitymentioning

confidence: 99%

“…Partial cystectomy has resulted in similar survival rates and higher rates of functional bladders compared with other treatment options. 36,67 Partial cystectomy usually is performed for bladder-dome tumors but may be applicable to more distal bladder lesions. These distal bladder resections may require ureteral reimplantation or bladder augmentation.…”

Section: Extremitymentioning

confidence: 99%

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