The role of surgery in the management of pediatric pelvic rhabdomyosarcoma

We assessed the role of surgery, particularly exenteration, in the treatment of children with lower urinary tract and pelvic rhabdomyosarcoma. We treated 23 children with bladder and/or prostate (11), or pelvic retroperitoneal tumors (12). Initial management was tumor resection in 6 cases, anterior...

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Bibliographic Details
Published inThe Journal of urology Vol. 154; no. 2 Pt 1; p. 540
Main Authors Lerner, S P, Hayani, A, O'Hollaren, P, Winkel, C, Ohori, M, Harberg, F J, Roth, D R, Gonzales, Jr, E T
Format Journal Article
LanguageEnglish
Published United States 01.08.1995
Subjects
Actuarial Analysis
Adolescent
Antineoplastic Combined Chemotherapy Protocols - therapeutic use
Child
Child, Preschool
Combined Modality Therapy
Female
Humans
Infant
Infant, Newborn
Male
Neoplasm Recurrence, Local - epidemiology
Pelvic Neoplasms - mortality
Pelvic Neoplasms - surgery
Pelvic Neoplasms - therapy
Prostatic Neoplasms - mortality
Prostatic Neoplasms - surgery
Prostatic Neoplasms - therapy
Retroperitoneal Neoplasms - mortality
Retroperitoneal Neoplasms - surgery
Retroperitoneal Neoplasms - therapy
Retrospective Studies
Rhabdomyosarcoma - drug therapy
Rhabdomyosarcoma - mortality
Rhabdomyosarcoma - radiotherapy
Rhabdomyosarcoma - surgery
Survival Rate
Urinary Bladder Neoplasms - mortality
Urinary Bladder Neoplasms - surgery
Urinary Bladder Neoplasms - therapy
Urinary Diversion
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Summary:We assessed the role of surgery, particularly exenteration, in the treatment of children with lower urinary tract and pelvic rhabdomyosarcoma. We treated 23 children with bladder and/or prostate (11), or pelvic retroperitoneal tumors (12). Initial management was tumor resection in 6 cases, anterior pelvic exenteration in 5 and biopsy only in 12, combined with chemotherapy in 23 and radiotherapy in 20. The bladder salvage rate for surviving patients with pelvic tumors was 92% versus 27% for those with prostate/bladder tumors. Estimated 5 and 10-year survival probability for patients with pelvic retroperitoneal tumors was 49 +/- 50% compared to 81 +/- 24% for those with bladder and/or prostate tumors (log rank test, p = 0.11). Exenterative surgery is frequently required to achieve a durable complete response.
ISSN:0022-5347
DOI:10.1016/S0022-5347(01)67106-4