Does the Less Aggressive Multimodal Approach of Treating Bladder-Prostate Rhabdomyosarcoma Preserve Bladder Function?

Soler, Roberto; Macedo, António; Bruschini, Homero; Puty, Fabiola Castelo Branco; Caran, Eliana Maria Monteiro; Petrilli, Antônio Sérgio; Garrone, Gilmar; Srougi, Miguel; Ortiz, Valdemar

doi:10.1097/01.ju.0000180644.32615.39

Cited by 21 publications

(14 citation statements)

References 13 publications

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“…This is probably a result of the aggressive radiotherapy for local tumor control in the IRS/COG trials . In an attempt to preserve bladder function, the treatment approach has shifted towards less aggressive operative management and an increased reliance on radiotherapy to achieve local control for patients with GU‐RMS . Unfortunately, according to several studies, radiotherapy is associated with treatment complications .…”

Section: Discussionmentioning

confidence: 99%

“…3,4,6 In an attempt to preserve bladder function, the treatment approach has shifted towards less aggressive operative management and an increased reliance on radiotherapy to achieve local control for patients with GU-RMS. 12,13 Unfortunately, according to several studies, radiotherapy is associated with treatment complications. 9,14,15 Partial cystectomy after radiotherapy can result in a small non-compliant bladder with intractable urinary frequency and incontinence.…”

Section: Discussionmentioning

confidence: 99%

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Reconstructive option after radical mutilating surgery in children with genitourinary rhabdomyosarcoma: When sparing the bladder is not an option

et al. 2016

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Objectives: To present versatile surgical reconstructive techniques and their outcomes in pediatric patients with genitourinary rhabdomyosarcoma. Methods: We retrospectively analyzed the oncological and urological outcomes of seven patients treated between 1992 and 2014 according to the Cooperative Weichteilsarkom Studiengruppe protocols. Intergroup Rhabdomyosarcoma Study staging: local, six patients; and IV, one patient. Histology: embryonal, five patients; unclassified, one patient; triton tumor one patient. Surgical treatment included: cystectomy, uterectomy and partial vaginectomy, one patient; radical cystectomy, two patients; cystectomy, one patient; cystectomy with partial prostatectomy, one patient; partial cystectomy, one patient; and partial prostatectomy, one patient. Results: All patients were alive in complete remission at last follow up. In four cases, ileal conduit with ureteral reimplantation with serous-lined extramural tunnel (Abol-Enein technique) was carried out, which was followed by conversion into ileal continent bladder with continent appendiceal stoma for clean intermittent catheterization in three patients. In one boy, partial cystectomy and continent reconstruction was carried out during a single surgical procedure. One child with incontinent urinary diversion is still awaiting a continence solution. One child after partial prostatectomy is continent without any voiding disturbances. Conclusions: The timing and extent of radical surgery for treatment of genitourinary rhabdomyosarcoma depend on the local anatomical conditions, and the response to previous chemo-and radiotherapy. Cystectomy followed by various reconstructive techniques still remains an important option in the local treatment.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Reconstructive option after radical mutilating surgery in children with genitourinary rhabdomyosarcoma: When sparing the bladder is not an option

et al. 2016

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“…Unfortunately, although the results of such studies in pediatric population are mostly preliminary, 18 they suggest that the outcome, even though initially acceptable, deteriorates over time. 19,20 Hence, late effects of irradiation of bladder and prostate during childhood on adult life remain unknown.…”

Section: Organ-sparing Surgerymentioning

confidence: 99%

“…It appears that about half the number of patients will have reduced bladder capacity, and the risk is higher in patients who receive pelvic radiotherapy. 26,30 Given the lack of systematically collected data on lower urinary tract function, this is an area where objective urodynamic measurements will provide an insight into long-term outcomes after RMS treatment. One of the very few papers trying to address this issue is a work by Raney 27 Median followup was 8 years.…”

Section: Bladder Function After Organ-sparing Surgerymentioning

confidence: 99%

A Review on Surgical Techniques and Organ Sparing Procedures in Bladder/Prostate Rhabdomyosarcoma

et al. 2014

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The treatment outcomes in children with bladder/prostate rhabdomyosarcoma (B/P RMS) have considerably improved in the past few decades. Current protocols incorporate chemotherapy, radiotherapy, and surgery (radical or organ sparing). Using this multimodal and multidisciplinary approach, the cure rates for nonmetastatic RMS have gradually increased from 25% in the 1970s, and 70% in the 1990s, to over 80% in the 2000s. Surgery plays a role not only in the diagnosis and management of all stages of B/P RMS, but also in the urinary reconstruction and long-term follow-up. Furthermore, the tendency to avoid mutilating surgery and to preserve functional genitourinary tract has been noticeable. Authors describe the current status and future surgical treatment approaches and possibilities for patients with B/P RMS and how reconstructive urologic surgery in B/P RMS continues to evolve.

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“…Currently, after chemotherapy, radiation therapy is the treatment most often used. Our group demonstrated by urodynamic study that with this approach bladder function was preserved in seven of eight children [1]. Of these, three had normal bladder function and four had only minor alterations.…”

Section: Introductionmentioning

confidence: 95%

Sexual function in teenagers after multimodal treatment of pelvic rhabdomyosarcoma: A preliminary report

Macedo

Ferreira

Barroso

et al. 2010

Journal of Pediatric Urology

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Does the Less Aggressive Multimodal Approach of Treating Bladder-Prostate Rhabdomyosarcoma Preserve Bladder Function?

Cited by 21 publications

References 13 publications

Reconstructive option after radical mutilating surgery in children with genitourinary rhabdomyosarcoma: When sparing the bladder is not an option

Reconstructive option after radical mutilating surgery in children with genitourinary rhabdomyosarcoma: When sparing the bladder is not an option

A Review on Surgical Techniques and Organ Sparing Procedures in Bladder/Prostate Rhabdomyosarcoma

Sexual function in teenagers after multimodal treatment of pelvic rhabdomyosarcoma: A preliminary report

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