What is the evidence for radical surgery in the management of localized embryonal bladder/prostate rhabdomyosarcoma?

Alexander, Nicholas; Lane, S.C.; Hitchcock, Rowena

doi:10.1002/pbc.24087

Cited by 19 publications

(13 citation statements)

References 22 publications

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“…3,4 However, whether these interventions should be incorporated into routine clinical practice also depends on the downsides associated with administration. For example, antibacterial prophylaxis has been reported to be associated with bacterial resistance, drug toxicity, CDI, and fungal infection 15 although we did not demonstrate the latter 2 outcomes in our analysis. Furthermore, 1 analysis suggested that prophylactic G-CSF may increase the risk of relapse in a subgroup of children with AML 16 although a similar adverse influence on disease control was not observed in a meta-analysis of G-CSF administration in AML.…”

Section: Discussioncontrasting

confidence: 52%

Effectiveness of supportive care measures to reduce infections in pediatric AML: a report from the Children’s Oncology Group

Sung

Aplenc

Alonzo

et al. 2013

Blood

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• Systemic antibacterial and granulocyte colony-stimulating factor prophylaxis appear to reduce bacterial infection rates.• Mandatory hospitalization during profound neutropenia did not reduce infection or significantly reduce nonrelapse-related mortality.Objective was to describe the effect of antibiotic and granulocyte colony-stimulating factor (G-CSF) prophylaxis and discharge policy on infection risk and nonrelapserelated mortality (NRM) during chemotherapy for children with acute myeloid leukemia.Patients were non-Down syndrome children enrolled on Children's Oncology Group (COG) trial AAML0531. We surveyed sites to determine institutional standards for systemic antibacterial, antifungal, and G-CSF prophylaxis, and mandatory hospitalization during neutropenia. COG institution survey response rate was 180 of 216 (83.3%).Of 1024 patients enrolled on AAML0531, 897 were non-Down patients from surveyresponding institutions. In multiple regression, antibacterial prophylaxis reduced any sterile-site bacterial infection (incidence rate ratio Mandatory hospitalization did not reduce bacterial/fungal infection or significantly reduce NRM but did increase CDI (IRR 1.96; 95% CI, 1.34-2.87; P < .001). Antibacterial and G-CSF prophylaxis reduced infection rates while mandatory hospitalization did not reduce infection or significantly affect NRM. This trial was registered at www. clinicaltrials.gov as #AAML0531. (Blood. 2013;121(18):3573-3577)

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Section: Discussioncontrasting

confidence: 52%

Effectiveness of supportive care measures to reduce infections in pediatric AML: a report from the Children’s Oncology Group

Sung

Aplenc

Alonzo

et al. 2013

Blood

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“…RT can be associated with significant late effects, particularly in young children . Surgery also can be associated with significant late effects, particularly if organs are sacrificed . In an effort to minimize RT toxicity, many European RMS trials have utilized RT selectively .…”

mentioning

confidence: 99%

Delayed primary excision with subsequent modification of radiotherapy dose for intermediate‐risk rhabdomyosarcoma: A report from the Children's Oncology Group Soft Tissue Sarcoma Committee

Rodeberg

Wharam

Lyden

et al. 2014

Intl Journal of Cancer

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The majority of intermediate risk Rhabdomyosarcoma (RMS) patients have gross residual disease (Group III) after their first operative procedure. It is currently not known if local control rates can be maintained when, following induction chemotherapy, the radiation therapy (RT) dose is decreased after a delayed primary excision (DPE). To answer this question we evaluated patients enrolled on COG D9803 (1999-2005) who had Group III tumors of the bladder dome, extremity, or trunk (thorax, abdomen, pelvis) were candidates for DPE at week 12 if the primary tumor appeared resectable. RT dose was then adjusted by the completeness of DPE: no evidence of disease (NED) 36 Gy, microscopic residual (MR) 41.4 Gy, and gross residual disease (GRD) 50.4 Gy. A total of 161 Group III patients were evaluated (24 bladder dome, 63 extremity, and 74 trunk). Seventy-three patients (45%) underwent DPE which achieved removal of all gross disease in 61 (84%) who were then eligible for reduced RT dose [43/73 received 36 Gy, 19/73 received 41.4 Gy]. The local 5-year failure rate (0% for bladder dome, 7% for extremity and 20% for trunk) was similar to IRS-IV, which did not encourage DPE and did not allow for DPE adapted RT dose reduction. In conclusion, DPE was performed in 45% of Group III RMS patients with tumors at select anatomic sites (bladder dome, extremity and trunk), and 84% of those who had DPE were eligible for RT dose reduction. Local control outcomes were similar to historic results with RT alone.

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“…Other less likely lesions in the differential diagnosis include Müllerian adenosarcoma and embryonal rhabdomyosarcoma. [32][33][34] Both these tumors may display a differentiated myogenic stroma, as well as periglandular condensation of CD10-positive stromal cells, as is typical of endometriosis. However, adenosarcomas display a distinctive leaf-like architectural pattern, and rhabdomyosarcomas are characterized by a skeletal muscle-like phenotype that is not seen in endometriosis.…”

Section: Discussionmentioning

confidence: 99%

Endomyometriosis (“Uterus - like mass”) in an XY Male

2014

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Male endometriosis and endomyometriosis (also termed "uterus-like mass") are 2 unusual manifestations of endometriosis. We report a case of male endomyometriosis with immunohistochemical and molecular confirmation. A 52-year-old man presented with stabbing pelvic pain. Computed tomography scan showed a mass in the right inguinal area, at the site of prior hernia repair. The lesion was tubular in shape, with a thick muscular wall and a central blood-filled lumen. Microscopically, the tissue showed layers of concentric smooth muscle, with endometrial glands and stroma lining the lumen. Many theories have been proposed regarding the etiology of both endomyometriosis and male endometriosis, including remnant rests of Müllerian tissue and metaplasia. Cases of male endometriosis typically have been linked to estrogen therapy for prostate cancer. Our patient had a history of cirrhosis and took spironolactone, possibly leading to an altered hormonal state that interacted with a reactive/metaplastic process at a site of prior surgery.

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What is the evidence for radical surgery in the management of localized embryonal bladder/prostate rhabdomyosarcoma?

Cited by 19 publications

References 22 publications

Effectiveness of supportive care measures to reduce infections in pediatric AML: a report from the Children’s Oncology Group

Effectiveness of supportive care measures to reduce infections in pediatric AML: a report from the Children’s Oncology Group

Delayed primary excision with subsequent modification of radiotherapy dose for intermediate‐risk rhabdomyosarcoma: A report from the Children's Oncology Group Soft Tissue Sarcoma Committee

Endomyometriosis (“Uterus - like mass”) in an XY Male

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