Optimal surgical treatment and urological outcomes in boys with pelvic and urogenital rhabdomyosarcomas and soft tissue sarcomas

被引：7

作者：

Hishiki, Tomoro ^{[1
,2
]}

Saito, Takeshi ^{[1
]}

Mitsunaga, Tetsuya ^{[1
]}

Nakata, Mitsuyuki ^{[1
]}

Terui, Elena ^{[1
]}

Komatsu, Shugo ^{[1
,2
]}

Mise, Naoko ^{[1
]}

Harada, Kazuaki ^{[1
]}

Iwai, Jun ^{[2
]}

Higashimoto, Yasuyuki ^{[2
]}

Okimoto, Yuri ^{[3
]}

Kakuda, Harumi ^{[3
]}

Ochiai, Hidemasa ^{[4
]}

Hino, Moeko ^{[4
]}

Homma, Sumie ^{[5
]}

Osa, Yuichi ^{[5
]}

Yoshida, Hideo ^{[1
]}

机构：

[1] Chiba Univ, Grad Sch Med, Dept Pediat Surg, Chuo Ku, Chiba 2608677, Japan

[2] Chiba Childrens Hosp, Dept Pediat Surg, Midori Ku, Chiba 2660077, Japan

[3] Chiba Childrens Hosp, Dept Hematol & Oncol, Midori Ku, Chiba 2660077, Japan

[4] Chiba Univ, Dept Pediat, Grad Sch Med, Chuo Ku, Chiba 2608677, Japan

[5] Chiba Childrens Hospy, Dept Urol, Midori Ku, Chiba 2660077, Japan

来源：

PEDIATRIC SURGERY INTERNATIONAL | 2013年 / 29卷 / 10期

关键词：

Soft tissue sarcoma; Rhabdomyosarcoma; Children; Surgery; Pelvis; NONMETASTATIC RHABDOMYOSARCOMA; BLADDER/PROSTATE RHABDOMYOSARCOMA; INTERNATIONAL-SOCIETY; PEDIATRIC-ONCOLOGY; STUDY-IV; CHILDHOOD; BLADDER; THERAPY;

D O I：

10.1007/s00383-013-3400-y

中图分类号：

R72 [儿科学];

学科分类号：

100202 ;

摘要：

Soft tissue sarcomas (STS) of pelvic origin in boys often involve the urogenital organs. The optimal extensiveness of radical surgery has long been an issue of discussion, since exenterative surgeries result in severe urogenital adverse effects. We conducted a retrospective review of patients with pelvic STS treated in two regional center hospitals and assessed the radicality of surgery and the functional outcome of the bladder. Medical records and surgical reports of nine cases (embryonal rhabdomyosarcoma 6, malignant triton tumor 2, suspected rhabdomyosarcoma 1) treated within 1997-2012 were reviewed. Site of origin was prostate in seven, retroperitoneal in two. Average follow-up period was 96 months. All cases were subjected to neoadjuvant chemotherapy. Response was PR in four, SD in two, and PD in two. Radical surgery resulted in gross total resection in eight, and partial resection in one. Three underwent cystoprostatectomy, two cases underwent prostatectomy, and bladder-preserving tumor resection was carried out in four cases. At the last follow-up, three retained a functional bladder. Two required augmentation cystoplasty with intestinal conduits. The majority of the on-going clinical trials recommend conservative surgery for bladder/prostate rhabdomyosarcoma, and to preserve the bladder function particularly in chemosensitive tumors. Some other groups, however, advocate the importance of radical surgery to prevent local relapse. These reports include heterogenous group of patients in the cohort, and therefore it is difficult to draw a conclusion of which approach truly contributes to the survival of the patients better. Future studies should evaluate bladder and sexual function objectively to establish reliable evidence regarding the benefit and adverse effects of different surgical approaches. These data would be informative to optimize the treatment balance for children with pelvic rhabdomyosarcomas.

引用

页码：1077 / 1082

页数：6

共 21 条

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