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Annals of Surgical Oncology

, Volume 23, Issue 12, pp 4067–4072 | Cite as

Improvements in the Treatment of Patients Suffering from Bladder-Prostate Rhabdomyosarcoma: A Report from the CWS-2002P Trial

  • Guido Seitz
  • Jörg Fuchs
  • Monika Sparber-Sauer
  • Ivo Leuschner
  • Jan Godzinski
  • Thomas Klingebiel
  • Andreas Schuck
  • Peter Martus
  • Tobias M. Dantonello
  • Ewa Koscielniak
Pediatric Oncology
  • 393 Downloads

Abstract

Purpose

Modern treatment concepts for bladder/prostate rhabdomyosarcoma (BPRMS) are designed to improve survival, to reduce therapy intensity, and to increase bladder preservation rates. Nevertheless, treatment is not optimal. The purpose of this study was to analyze BPRMS patients treated within the CWS-2002P trial regarding outcome, treatment modalities, complications, and to compare the data with the precursor trial CWS-96.

Methods

Fifty children with localized embryonal BPRMS were analyzed. Eight patients were excluded. Patients received neoadjuvant chemotherapy. At week 9, reassessment using MRI scan was performed. Depending on tumor size, age, and response, local therapy consisting of radiotherapy and/or surgery was initiated. After local therapy, systemic therapy was continued.

Results

Patients’ median age was 35.6 months. Median follow-up was 59 months. The 5-year OS was 84.5 % and the 5-year ES 79.9 %. Ten patients underwent combined radiochemotherapy and tumor resection (5-year ES: 87.5 %). Six patients were treated solely with radiochemotherapy (5-year ES: 60 %). Twenty-six patients received preoperative chemotherapy followed by tumor resection (ES: 80.8). One patient was treated with chemotherapy only and survived. The bladder preservation rate was 80.9 %.

Conclusions

The outcome within the CWS-2002P trial regarding OS and ES seemed to be better than in the precursor trial CWS-96 due to a reduction of protocol violations, but there was no statistical significant difference possibly due to low numbers. Radiotherapy was used less frequently, and the bladder preservation rate was slightly higher. Novel concepts will be required in the future to improve bladder preservation rates.

Keywords

Overall Survival Protocol Violation Primary Tumor Resection Salvage Radiotherapy Combine Radiochemotherapy 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.

Notes

Acknowledgment

The authors acknowledge Iris Veit, Simone Feuchtgruber, and Erika Hallmen for their tremendous help acquiring data for this paper. Additionally, they thank all contributing centers, physicians, parents, and patients for contributing the CWS-2002P trial and the German Cancer Aid for the financial support (founded from 2002–2005, Project No. 50-2721).

Disclosure

The authors state no conflict of interest.

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Copyright information

© Society of Surgical Oncology 2016

Authors and Affiliations

  • Guido Seitz
    • 1
    • 2
  • Jörg Fuchs
    • 1
  • Monika Sparber-Sauer
    • 3
  • Ivo Leuschner
    • 4
  • Jan Godzinski
    • 5
  • Thomas Klingebiel
    • 6
  • Andreas Schuck
    • 7
  • Peter Martus
    • 8
  • Tobias M. Dantonello
    • 3
  • Ewa Koscielniak
    • 3
  1. 1.Department of Pediatric Surgery and Pediatric UrologyUniversity Children’s HospitalTübingenGermany
  2. 2.Department of Pediatric SurgeryUniversity Hospital MarburgMarburgGermany
  3. 3.Department of Pediatric Hematology/OncologyOlgahospital, Klinikum StuttgartStuttgartGermany
  4. 4.Department of Pediatric PathologyUniversity HospitalKielGermany
  5. 5.Department of Pediatric SurgeryMarciniak HospitalWroclawPoland
  6. 6.University Hospital for Pediatric Hematology/OncologyFrankfurtGermany
  7. 7.Department of RadiotherapyUniversity HospitalMünsterGermany
  8. 8.Department of Clinical Epidemiology and Applied BiometryUniversity of TuebingenTübingenGermany

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