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Genitourinary rhabdomyosarcoma in children
Author(s) -
Loughlin Kevin R.,
Retik Alan B.,
Weinstein Howard J.,
Colodny Arnold H.,
Shamberger Robert C.,
Delorey Marcia,
Tarbell Nancy,
Robert Cassady J.,
Hardy Hendren W.
Publication year - 1989
Publication title -
cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 3.052
H-Index - 304
eISSN - 1097-0142
pISSN - 0008-543X
DOI - 10.1002/1097-0142(19890415)63:8<1600::aid-cncr2820630826>3.0.co;2-p
Subject(s) - medicine , rhabdomyosarcoma , genitourinary system , radiation therapy , surgery , dissection (medical) , prostate , lymph node , sarcoma , cancer , pathology
Although rhabdomyosarcoma of the genitourinary tract occurs infrequently in children, it presents a challenging problem to the surgeon, radiotherapist, and oncologist. Thirty‐six children with genitourinary rhabdomyosarcoma were treated at our institutions from 1957 to 1985. The primary site of tumor involved the bladder, prostate, or both in 15 patients, the paratesticular structures in 12, and female reproductive organs in nine. Although treatment modalities and philosophies of care varied over the past 27 years, the majority of patients were treated with a combination of surgery, chemotherapy, and radiation therapy. The event‐free survival for all patients is 74%. Patients with paratesticular tumors had the best prognosis (88% event‐free survival). Regional nodal radiation therapy is not necessary in this favorable group if the retroperitoneal lymph node dissection is negative. Of 15 children with bladder/prostate tumors nine had initial conservative surgery. Of these nine six are long‐term survivors, but only three patients have intact bladders. The girls with tumors of the reproductive organs had an event‐free survival of 63%; all patients in this group had hysterectomies. Chemotherapy and radiotherapy have not substituted for radical surgical procedures in most children with bladder or prostate rhabdomyosarcomas. Innovative therapeutic approaches are necessary for this group of patients.