The Role of Surgery in the Management of Pediatric Pelvic Rhabdomyosarcoma

Lerner, Seth P.; Hayani, Ammar; O'Hollaren, Patrick; Winkel, Carrie; Ohori, Makoto; Harberg, Franklin J.; Roth, David R.; Gonzales, Edmond T.

doi:10.1016/s0022-5347(01)67106-4

Cited by 19 publications

(7 citation statements)

References 20 publications

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“…Available long-term data show a greater rate of local recurrences and death from disease in patients undergoing chemotherapy with or without radiotherapy only [19][20][21][22]. The aim of stratifying patients into low-and high-risk categories using the tumour response to initial chemotherapy was recently assessed [23].…”

Section: Discussionmentioning

confidence: 99%

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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%

“…However, radical surgery gave long-term survival rates of >80% [22], when used before the appearance of distant metastases. About 75% of RMS of the bladder have their origin in the area of the bladder base or prostate, whereas only 25% are in the mobile part of the bladder, lending themselves to an organ-sparing approach [28].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2003

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“…4 In this case, the priority is to preserve renal function achieving maximum survival rates and trying to, if possible, facilitate the conversion to a continent ostomy of abdominal catheterization. 5 When analyzing the options for continent diversions, one should note the tendency for the use of intestinal segments located outside the irradiated area (transverse colon, proximal ileum), which is justified by the complications that occur in previously irradiated intestinal segments, like actinic obliterating endarteritis. 6 When the appendix remains intact, its use as an efferent, abdominally catheterizable conduit is well established (the Mitrofanoff Principle).…”

Section: Discussionmentioning

confidence: 99%

Continent urinary reconstruction in rhabdomyosarcoma: A new approach

Freitas¹,

Nobre²,

Macedo³

et al. 2004

Journal of Pediatric Surgery

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“…15,19,50 Many interesting conclusions were made from these studies. Flamant and Hill 58 in a large study population of 345 (24% were GU), described an impressive improvement in survival from 30 to 50% when combination CTX was used over single-agent CTX in addition to surgery with or without RT.…”

Section: Single-institutional Trialsmentioning

confidence: 91%

“…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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The Role of Surgery in the Management of Pediatric Pelvic Rhabdomyosarcoma

Cited by 19 publications

References 20 publications

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

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

Continent urinary reconstruction in rhabdomyosarcoma: A new approach

Treatment modalities of bladder/prostate rhabdomyosarcoma: a review

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