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Bladder Cancer
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my personal edition > bladder cancer > news
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DGReview
Primary Chemotherapy Followed By Radical Surgery Of Rhabdomyosarcoma Of The Bladder Or Prostate Appears to Yield Excellent Cure Rates
A DGReview of :"Rhabdomyosarcoma of the bladder, prostate or vagina: the role of surgery"
British Journal of Urology (BJU International)
01/08/2004
By Jill Taylor
Primary chemotherapy followed by radical surgery of rhabdomyosarcoma (RMS) of the prostate and/or bladder allows complete tumour resection in the majority of cases and gives excellent cure rates in nearly 80% of patients, say researchers.
Approximately 20% of RMS, a rare tumour occurring in children, arises from the genitourinary tract. Once treated solely by surgery, RMS treatment options currently include chemotherapy and radiotherapy, resulting in organ preservation and a substantially better prognosis.
To evaluate the role of radical surgery in patients with RMS of the prostate and/or bladder, Dragana Filipas, MD, of the University of Vienna, Austria, and colleagues retrospectively analysed the outcome of 22 children who were treated with chemotherapy, with or without radical surgery or additional radiotherapy.
Among the subjects, 20 had received primary polychemotherapy (vincristine, actinomycin D, cyclophosphamide, adriamycin, and later, etoposide and ifosfamide), and 7 had additional radiotherapy. Radical surgery was used in 14 cases, as primary treatment in 2 patients, after chemotherapy in 11 patients, and during disease progression under chemotherapy in 1 patient.
After a mean follow up of 8.6 years, 5 children with an advanced tumour stage had died and the remaining 17 children had no evidence of disease.
Complications included bladder contraction after radiotherapy requiring bladder augmentation (2 children), ureteric stenosis after irradiation and continent cutaneous diversion requiring ureteric reimplantation (1 child), ureteric implantation stenosis requiring reimplantaion (1 child), and early pouch perforation by catheter dislocation requiring surgical revision (1 child).
"Preserving bladder function so that the patients' quality of life is not compromised carries the risk of higher rates of positive margins and tumour relapse," the investigators said. "Radical surgery and current techniques of continent urinary diversion allow for high cure rates and a good quality of life in these children."
Br J Urol 2004 Jan;93:1:125-9.
"Rhabdomyosarcoma of the bladder, prostate or vagina: the role of surgery"
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