1
|
Martynov I, Sparber-Sauer M, Heinz A, Vokuhl MC, Ebinger M, Gesche J, Münter M, Koscielniak E, Fuchs J, Seitz G. Importance of Adequate Surgical Local Control in Fusion-Negative Para-Testicular Rhabdomyosarcoma: Data From the Cooperative Weichteilsarkom Studiengruppe Trials (CWS-96 and CWS-2002P) and the European Soft Tissue Sarcoma Registry (SoTiSaR). Ann Surg Oncol 2024; 31:6209-6219. [PMID: 38879672 PMCID: PMC11300477 DOI: 10.1245/s10434-024-15568-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2024] [Accepted: 05/22/2024] [Indexed: 08/09/2024]
Abstract
BACKGROUND This study aimed to assess the impact that the quality of primary and subsequent surgeries has on the survival of patients with para-testicular rhabdomyosarcoma (PTRMS). METHODS Patients with localized (IRS I-III) and metastatic (IRS IV) PTRMS were enrolled in the two Cooperative Weichteilsarkom Studiengruppe (CWS) trials (CWS-96, CWS-2002P) and the Soft Tissue Sarcoma Registry (SoTiSaR). RESULTS Among 196 patients (median age, 8.4 years), 106 (54.1%) had primary complete resection. Image-defined lymph node (LN) disease was detected in 21 (11.5%) patients in the localized cohort and 12 (92.3%) patients in the metastatic cohort. The 5-year event-free survival (EFS) and overall survival (OS) were respectively 87.3% and 94.0% for the patients with localized PTRMS and 46.2% and 42.2% for the patients with metastatic PTRMS. Protocol violations during the primary surgery (PV-PS) were observed in 70 (42%) of the IRS I-III patients. This resulted in higher rates of R1/R2 resections (n = 53 [76%] vs n = 20 [21%]; p < 0.001) with a need for pretreatment re-excision (PRE) (n = 50 [83%] vs n = 10 [17%]; p < 0.001) compared with the patients undergoing correct primary surgery. Protocol violations during PRE occurred for 13 (20%) patients. Although PV-PS did not influence the 5-year EFS or OS in the localized PTRMS cohort, the unadjusted log-rank test showed that R status after PRE is a prognostic factor for 5-year OS (R1 vs R0 [81.8% vs 97.6%]; p = 0.02). CONCLUSIONS The quality of surgical local control in PTRMS is unsatisfactory. Emphasis should be placed on evaluating the resection status after PRE in further clinical trials.
Collapse
Grants
- The CWS-96, and -2002P trials were supported by grants from the German Cancer Aid Foundation, Bonn, Germany (CWS-96: T9/96/TrI, CWS-2002P: 50-2721-Tr2). The registry (SoTiSaR), was supported by the Deutsche Kinderkrebsstiftung, Bonn, Germany, grant no. A2007/13DKS2009.08, A2012/04DKS2012.05, A2015/16DKS2015.12, A2018/04DKS2018/09and by the Foerderkreis Krebskranke Kinder Stuttgart, Germany.
- Philipps-Universität Marburg (1009)
Collapse
Affiliation(s)
- Illya Martynov
- Department of Pediatric Surgery and Urology, University Hospital Giessen-Marburg, Philipps-University, Campus Marburg, Marburg, Germany.
- Department of Pediatric Surgery, University Hospital Giessen-Marburg, Campus Giessen, Giessen, Germany.
| | - Monika Sparber-Sauer
- Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Stuttgart, Germany
- University of Medicine Tübingen, Tübingen, Germany
| | - Amadeus Heinz
- Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Stuttgart, Germany
- Department of Pediatric Hematology and Oncology, University Children´s Hospital, Tuebingen, Germany
| | - M Christian Vokuhl
- Section of Pediatric Pathology, Department of Pathology, University Hospital Bonn, Bonn, Germany
| | - Martin Ebinger
- Department of Pediatric Hematology and Oncology, University Children´s Hospital, Tuebingen, Germany
| | - Jens Gesche
- Pediatric Surgery, Josefinum, Augsburg, Germany
| | - Marc Münter
- Department of Radiooncology, Klinikum Stuttgart, Stuttgart, Germany
| | - Ewa Koscielniak
- Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Stuttgart, Germany
| | - Jörg Fuchs
- Department of Pediatric Surgery and Urology, University Children's Hospital, Tuebingen, Germany
| | - Guido Seitz
- Department of Pediatric Surgery and Urology, University Hospital Giessen-Marburg, Philipps-University, Campus Marburg, Marburg, Germany
- Department of Pediatric Surgery, University Hospital Giessen-Marburg, Campus Giessen, Giessen, Germany
| |
Collapse
|
2
|
Pachl M, Lautz TB, Aldrink JH, Abdelhafeez H, Irtan S. Minimally invasive and robotic-assisted approaches applied to pediatric surgical oncology. Pediatr Blood Cancer 2024:e31162. [PMID: 38987997 DOI: 10.1002/pbc.31162] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2024] [Accepted: 06/12/2024] [Indexed: 07/12/2024]
Abstract
The management of pediatric tumors is complex, with surgery, chemotherapy, and radiotherapy being cornerstones in their treatment. Tumor removal is increasingly performed by a minimally invasive approach, which allows for quicker postoperative recovery and less postoperative pain. The goal of this report is to give an overview of minimally invasive surgical approaches for common pediatric tumors, with a focus on technical considerations and postoperative outcomes.
Collapse
Affiliation(s)
- Max Pachl
- Department of Pediatric Surgery and Urology, Birmingham Children's Hospital, Birmingham Women's and Children's NHS Foundation Trust, Birmingham, UK
| | - Timothy B Lautz
- Division of Pediatric Surgery, Ann & Robert H Lurie Children's Hospital of Chicago, Northwestern University, Chicago, Illinois, USA
| | - Jennifer H Aldrink
- Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, Ohio, USA
| | - Hafeez Abdelhafeez
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, Tennessee, USA
- Department of Surgery, University of Tennessee Health Science Center, Memphis, Tennessee, USA
| | - Sabine Irtan
- Department of Visceral and Neonatal Pediatric Surgery, Hôpital Armand Trousseau - APHP, Sorbonne University, Paris, France
| |
Collapse
|
3
|
Totadri S, Bansal D, Donaldson SS, Binitie O, Teot L, Gupta AA, Oberoi S. Common queries in managing rhabdomyosarcoma in low- and middle-income countries: An Indo-North American collaboration. Pediatr Blood Cancer 2023; 70:e30616. [PMID: 37574816 DOI: 10.1002/pbc.30616] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/09/2023] [Revised: 07/01/2023] [Accepted: 07/24/2023] [Indexed: 08/15/2023]
Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma among children and adolescents. The management of RMS involves risk stratification of the patients based on various clinicopathological characteristics. The multimodality treatment approach requires chemotherapy, surgery, and/or radiation. The treatment of RMS necessitates the involvement of multiple disciplines, such as pathology, pediatric oncology, surgery, and radiation oncology. The disease heterogeneity, molecular testing, evolving treatment regimens, and limited resources are some of the challenges faced by clinicians while treating a patient with RMS in low- and middle-income countries (LMICs). In this review, we endeavor to bring experts from varying fields to address clinicians' common questions while managing a child or adolescent with RMS in LMICs. This review is most applicable to level 2 centers in LMICs as per the levels of services described by the Adapted Treatment Regimens Working Group of the Pediatric Oncology in Developing Countries committee of the International Society of Pediatric Oncology.
Collapse
Affiliation(s)
- Sidharth Totadri
- Department of Paediatrics, Paediatric Haematology-Oncology Unit, Christian Medical College, Vellore, India
| | - Deepak Bansal
- Department of Pediatrics, Postgraduate Institute of Medical Education and Research, Pediatric Hematology-Oncology Unit, Advanced Pediatrics Center, Chandigarh, India
| | - Sarah S Donaldson
- Department of Radiation Oncology, Stanford University, Stanford, California, USA
| | - Odion Binitie
- Department of Sarcoma, Lee Moffitt Cancer Center and Research Institute, Tampa, Florida, USA
| | - Lisa Teot
- Department of Pathology, Boston Children's Hospital/Harvard Medical School, Boston, Massachusetts, USA
| | - Abha A Gupta
- Division of Pediatric Hematology-Oncology, The Hospital for Sick Children, Toronto, Ontario, Canada
| | - Sapna Oberoi
- Department of Pediatric Hematology-Oncology, CancerCare Manitoba, Winnipeg, Canada
- Department of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
| |
Collapse
|
4
|
Polites SF, Rhee DS, Routh JC, Lautz TB, Rodeberg DA, Dasgupta R. Critical elements of pediatric rhabdomyosarcoma surgery. Semin Pediatr Surg 2023; 32:151341. [PMID: 38042091 DOI: 10.1016/j.sempedsurg.2023.151341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/04/2023]
Abstract
Rhabdomyosarcoma (RMS), the most common soft tissue sarcoma in children, requires multimodal therapy which is determined by risk group stratification. Local control may be achieved by surgical resection, radiation, or both. Resection may occur upfront or following induction chemotherapy as a delayed primary excision. An R1 resection may allow a reduction in radiation exposure; however, debulking is not indicated nor is excision of residual masses at the end of therapy. Regional lymph node assessment is an important component of surgical care, as positive nodal basins require radiation. Depending on the tumor site and biology, sentinel lymph node biopsy vs biopsy of clinically or radiographically concerning nodes is indicated. Therapeutic lymph node dissection is never indicated. Familiarity with site-specific oncologic principles for RMS and participation in a multidisciplinary team including Pediatric Oncology and Radiation Oncology are necessary components of surgical care to ensure optimal outcomes.
Collapse
Affiliation(s)
- Stephanie F Polites
- Division of Pediatric Surgery, Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Daniel S Rhee
- Division of General Pediatric Surgery, Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD, USA
| | - Jonathan C Routh
- Department of Urology, Duke University School of Medicine, Durham, NC, USA
| | - Timothy B Lautz
- Division of Pediatric Surgery, Ann & Robert H Lurie Children's Hospital of Chicago, Northwestern University, Chicago, IL, USA
| | - David A Rodeberg
- Department of Surgery, Department of Pediatric Surgery, University of Kentucky, Lexington, KY, USA
| | - Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Medical Center, University of Cincinnati, Cincinnati, OH, USA.
| |
Collapse
|
5
|
Schoot RA, van Ewijk R, von Witzleben AA, Kao SC, Merks JHMH, Morosi C, Pace E, Shulkin BL, Ferrari A, von Kalle T, van Rijn RR, Weiss AR, Sparber-Sauer M, Ter Horst SAJ, McCarville MB. INternational Soft Tissue saRcoma ConsorTium (INSTRuCT) consensus statement: Imaging recommendations for the management of rhabdomyosarcoma. Eur J Radiol 2023; 166:111012. [PMID: 37541182 DOI: 10.1016/j.ejrad.2023.111012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/19/2023] [Revised: 07/19/2023] [Accepted: 07/24/2023] [Indexed: 08/06/2023]
Abstract
Rhabdomyosarcoma is the most common soft-tissue neoplasm in the pediatric population. The survival of children with rhabdomyosarcoma has only marginally improved over the past 25 years and remains poor for those with metastatic disease. A significant challenge to advances in treatment of rhabdomyosarcoma is the relative rarity of this disease, necessitating years to complete clinical trials. Progress can be accelerated by international cooperation and sharing national experiences. This necessitates agreement on a common language to describe patient cohorts and consensus standards to guide diagnosis, treatment, and response assessment. These goals formed the premise for creating the INternational Soft Tissue saRcoma ConsorTium (INSTRuCT) in 2017. Multidisciplinary members of this consortium have since developed international consensus statements on the diagnosis, treatment, and management of pediatric soft-tissue sarcomas. Herein, members of the INSTRuCT Diagnostic Imaging Working Group present international consensus recommendations for imaging of patients with rhabdomyosarcoma at diagnosis, at staging, and during and after completion of therapy. The intent is to promote a standardized imaging approach to pediatric patients with this malignancy to create more-reliable comparisons of results of clinical trials internationally, thereby accelerating progress in managing rhabdomyosarcoma and improving survival.
Collapse
Affiliation(s)
- Reineke A Schoot
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Roelof van Ewijk
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Anna-Anais von Witzleben
- Institute of Radiology Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin, Klinikum Stuttgart, Stuttgart, Germany.
| | - Simon C Kao
- Department of Radiology, The University of Iowa Carver College of Medicine, Iowa City, IA, USA.
| | - J H M Hans Merks
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands.
| | - Carlo Morosi
- Department of Radiology, Istituto Nazionale Tumori, Milan, Italy.
| | - Erika Pace
- Department of Radiology, The Royal Marsden NHS Foundation Trust, London, England, United Kingdom.
| | - Barry L Shulkin
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA.
| | - Andrea Ferrari
- Pediatric Oncology Unit, Medical Oncology and Hematology Department, Istituto Nazionale Tumori, Milan, Italy.
| | - Thekla von Kalle
- Institute of Radiology Olgahospital, Zentrum für Kinder-, Jugend- und Frauenmedizin, Klinikum Stuttgart, Stuttgart, Germany.
| | - Rick R van Rijn
- Department of Radiology and Nuclear Medicine, Emma Children's Hospital, Amsterdam UMC, University of Amsterdam, Amsterdam, the Netherlands.
| | - Aaron R Weiss
- Department of Pediatrics, Division of Pediatric Hematology-Oncology, Maine Medical Center, Portland, ME, USA.
| | - Monika Sparber-Sauer
- Klinikum der Landeshauptstadt Stuttgart gKAöR, Olgahospital, Stuttgart Cancer Center, Zentrum für Kinder-, Jugend- und Frauenmedizin, Pädiatrie 5 (Pädiatrische Onkologie, Hämatologie, Immunologie), Stuttgart, Germany; University of Medicine Tübingen, Tübingen, Germany.
| | - Simone A J Ter Horst
- Princess Máxima Center for Pediatric Oncology, Utrecht, the Netherlands; Department of Radiology and Nuclear Medicine, Wilhelmina Children's Hospital/University Medical Centre Utrecht, Utrecht, the Netherlands.
| | - M Beth McCarville
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN, USA.
| |
Collapse
|
6
|
Castle JT, Levy BE, Allison DB, Rodeberg DA, Rellinger EJ. Pediatric Rhabdomyosarcomas of the Genitourinary Tract. Cancers (Basel) 2023; 15:2864. [PMID: 37345202 PMCID: PMC10216134 DOI: 10.3390/cancers15102864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2023] [Revised: 05/19/2023] [Accepted: 05/20/2023] [Indexed: 06/23/2023] Open
Abstract
Rhabdomyosarcoma (RMS) is the most common soft tissue sarcoma in the pediatric and adolescent population, with 350 new cases diagnosed each year. While they can develop anywhere in the body, the genitourinary tract is the second most common primary location for an RMS to develop. Overall survival has improved through the increased use of protocols and multidisciplinary approaches. However, the guidelines for management continue to change as systemic and radiation therapeutics advance. Given the relative rarity of this disease compared to other non-solid childhood malignancies, healthcare providers not directly managing RMS may not be familiar with their presentation and updated management. This review aims to provide foundational knowledge of the management of RMSs with an emphasis on specific management paradigms for those arising from the genitourinary tract. The genitourinary tract is the second most common location for an RMS to develop but varies greatly in symptomology and survival depending on the organ of origin. As the clinical understanding of these tumors advances, treatment paradigms have evolved. Herein, we describe the breadth of presentations for genitourinary RMSs with diagnostic and treatment management considerations, incorporating the most recently available guidelines and societal consensus recommendations.
Collapse
Affiliation(s)
- Jennifer T. Castle
- Department of Surgery, Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA;
| | - Brittany E. Levy
- Department of Surgery, University of Kentucky, Lexington, KY 40536, USA;
| | - Derek B. Allison
- Department of Pathology and Laboratory Medicine, Department of Urology, Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA;
| | - David A. Rodeberg
- Department of Surgery, Department of Pediatric Surgery, University of Kentucky, Lexington, KY 40536, USA;
| | - Eric J. Rellinger
- Department of Surgery, Department of Pediatric Surgery, Markey Cancer Center, University of Kentucky, Lexington, KY 40536, USA
| |
Collapse
|
7
|
Castle JT, Levy BE, Rodeberg DA. Abdominal Tumors. Surg Clin North Am 2022; 102:715-737. [DOI: 10.1016/j.suc.2022.07.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
8
|
Kube P, Parisio K, Mangum DS, Powell J. Fusion-negative rhabdomyosarcoma with diffuse bony metastases and remarkable chemosensitivity. BMJ Case Rep 2022; 15:e250236. [PMID: 36038153 PMCID: PMC9438076 DOI: 10.1136/bcr-2022-250236] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/25/2022] [Indexed: 11/04/2022] Open
Abstract
In this report, we describe the case of an adolescent male with an unusual case of fusion-negative, paratesticular alveolar rhabdomyosarcoma who presented with spontaneous tumour lysis syndrome and diffuse bony metastases throughout the axial and appendicular skeleton with additional significant bone marrow involvement. Both spontaneous tumour lysis syndrome and diffuse bony metastases are extremely unusual for rhabdomyosarcoma. On the backbone of standard vincristine, dactinomycin and cyclophosphamide (VAC) chemotherapy, the only local control was orchiectomy at 15 weeks, with no radiation administered due to the initially diffuse nature of the disease and rapid response to chemotherapy. Following 43 weeks of VAC, a year-long maintenance phase with pazopanib was given which was well tolerated. The patient remains in remission now 4 years after completion of therapy.
Collapse
Affiliation(s)
- Paige Kube
- Department of Pediatrics, Nemours Children's Hospital Delaware, Wilmington, Delaware, USA
| | - Katie Parisio
- Department of Hematology/Oncology and Department of Palliative Medicine, Nemours Children's Hospital Delaware, Wilmington, Delaware, USA
| | - David Spencer Mangum
- Division of Hematology/Oncology, Department of Pediatrics, University of Utah and Primary Children's Hospital, Salt Lake City, Utah, USA
| | - Jonathan Powell
- Department of Pediatrics, Nemours Children's Hospital Delaware, Wilmington, Delaware, USA
| |
Collapse
|
9
|
Crane JN, Xue W, Qumseya A, Gao Z, Arndt CA, Donaldson SS, Harrison DJ, Hawkins DS, Linardic CM, Mascarenhas L, Meyer WH, Rodeberg DA, Rudzinski ER, Shulkin BL, Walterhouse DO, Venkatramani R, Weiss AR. Clinical group and modified TNM stage for rhabdomyosarcoma: A review from the Children's Oncology Group. Pediatr Blood Cancer 2022; 69:e29644. [PMID: 35253352 PMCID: PMC9233945 DOI: 10.1002/pbc.29644] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/21/2021] [Revised: 02/10/2022] [Accepted: 02/11/2022] [Indexed: 12/14/2022]
Abstract
The Children's Oncology Group (COG) uses Clinical Group (CG) and modified Tumor Node Metastasis (TNM) stage to classify rhabdomyosarcoma (RMS). CG is based on surgicopathologic findings and is determined after the completion of initial surgical procedure(s) but prior to chemotherapy and/or radiation therapy. The modified TNM stage is based on clinical and radiographic findings and is assigned prior to any treatment. These systems have evolved over several decades. We review the history, evolution, and rationale behind the current CG and modified TNM classification systems used by COG for RMS. Data from the seven most recently completed and reported frontline COG trials (D9602, D9802, D9803, ARST0331, ARST0431, ARST0531, ARST08P1) were analyzed, and confirm that CG and modified TNM stage remain relevant and useful for predicting prognosis in RMS. We propose updates based on recent data and discuss factors warranting future study to further optimize these classification systems.
Collapse
Affiliation(s)
| | - Wei Xue
- Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL
| | - Amira Qumseya
- Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL
| | - Zhengya Gao
- Department of Biostatistics, College of Public Health and Health Professions and College of Medicine, University of Florida, Gainesville, FL
| | - Carola A.S. Arndt
- Department of Pediatric and Adolescent Medicine, Mayo Clinic and Foundation, Rochester, MN
| | | | - Douglas J. Harrison
- Department of Pediatrics, Texas Children's Cancer Center, Baylor College of Medicine, Houston, TX
| | - Douglas S. Hawkins
- Department of Pediatrics, Seattle Children's Hospital, University of Washington School of Medicine, Seattle, WA
| | | | - Leo Mascarenhas
- Children's Hospital Los Angeles and University of Southern California Keck School of Medicine, Los Angeles, CA
| | - William H. Meyer
- University of Oklahoma Health Sciences Center, Oklahoma City, OK
| | - David A. Rodeberg
- Division of Pediatric Surgery, Department of Surgery, East Carolina University, Greenville, NC
| | - Erin R. Rudzinski
- Department of Laboratories, Seattle Children’s Hospital, Seattle, WA
| | - Barry L. Shulkin
- Department of Diagnostic Imaging, St. Jude Children's Research Hospital, Memphis, TN
| | - David O. Walterhouse
- Department of Pediatrics, Ann & Robert H. Lurie Children's Hospital of Chicago, Northwestern University Feinberg School of Medicine, Chicago, IL
| | | | - Aaron R. Weiss
- Department of Pediatrics, Maine Medical Center, Portland, ME
| |
Collapse
|
10
|
de Campos Vieira Abib S, Chui CH, Cox S, Abdelhafeez AH, Fernandez-Pineda I, Elgendy A, Karpelowsky J, Lobos P, Wijnen M, Fuchs J, Hayes A, Gerstle JT. International Society of Paediatric Surgical Oncology (IPSO) Surgical Practice Guidelines. Ecancermedicalscience 2022; 16:1356. [PMID: 35510137 PMCID: PMC9023308 DOI: 10.3332/ecancer.2022.1356] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2021] [Indexed: 12/14/2022] Open
Abstract
Most children with tumors will require one or more surgical interventions as part of the care and treatment, including making a diagnosis, obtaining adequate venous access, performing a surgical resection for solid tumors (with staging and reconstruction), performing procedures for cancer prevention and its late effects, and managing complications of treatment; all with the goal of improving survival and quality of life. It is important for surgeons to adhere to sound pediatric surgical oncology principles, as they are closely associated with improved local control and survival. Unfortunately, there is a significant disparity in survival rates in low and middle income countries, when compared to those from high income countries. The International Society of Paediatric Surgical Oncology (IPSO) is the leading organization that deals with pediatric surgical oncology worldwide. This organization allows experts in the field from around the globe to gather and address the surgical needs of children with cancer. IPSO has been invited to contribute surgical guidance as part of the World Health Organization Initiative for Childhood Cancer. One of our goals is to provide surgical guidance for different scenarios, including those experienced in High- (HICs) and Low- and Middle-Income Countries (LMICs). With this in mind, the following guidelines have been developed by authors from both HICs and LMICs. These have been further validated by experts with the aim of providing evidence-based information for surgeons who care for children with cancer. We hope that this initiative will benefit children worldwide in the best way possible. Simone Abib, IPSO President Justin T Gerstle, IPSO Education Committee Chair Chan Hon Chui, IPSO Secretary.
Collapse
Affiliation(s)
- Simone de Campos Vieira Abib
- Pediatric Oncology Institute, GRAACC, Federal University of São Paulo, Rua Pedro de Toledo, 572 - Vila Clementino, São Paulo, SP 04021-001, Brazil
| | - Chan Hon Chui
- Surgery Centre for Children, Mount Elizabeth Medical Centre, 3 Mount Elizabeth, 228510, Singapore
| | - Sharon Cox
- Division of Paediatric Surgery, Red Cross War Memorial Children’s Hospital, University of Cape Town, Cape Town, South Africa
| | - Abdelhafeez H Abdelhafeez
- Department of Surgery, St Jude Research Hospital 262 Danny Thomas Place. MS133, Memphis, TN 38105, USA
| | - Israel Fernandez-Pineda
- Department of Pediatric Surgery, Virgen del Rocio Children’s Hospital, Av Manuel Siurot S/NN, Sevilla 41013, Spain
| | - Ahmed Elgendy
- Surgical Oncology Unit, Faculty of Medicine, Tanta University, Elgiesh Street, 31111, Tanta, Gharbeya, Egypt
| | - Jonathan Karpelowsky
- Department of Paediatric Surgery, Children’s Hospital at Westmead, Westmead NSW 2145, Australia
| | - Pablo Lobos
- Pediatric Surgery Division, Hospital Italiano de Buenos Aires, Andrés Lamas 812, Buenos Aires 1406, Argentina
| | - Marc Wijnen
- Department of Surgery, Princess Maxima Center for Pediatric Oncology, Huispostnummer KE 01.129.2, Postbus 85090, Utretcht 3508AB, The Netherlands
| | - Jörg Fuchs
- Department of Pediatric Surgery and Pediatric Urology, University of Tuebingen, Hoppe-Seyler-Str. 3, Tübingen 72076, Germany
| | - Andrea Hayes
- Department of Surgery, Howard University Hospital, 1851 9th Street NW, 4th Floor, Washington, DC 20059, USA
| | - Justin T Gerstle
- Department of Surgery, Memorial Sloan Kettering Cancer Center, 1275 York Avenue, New York, NY 10065, USA
| |
Collapse
|
11
|
Rogers TN, Seitz G, Fuchs J, Martelli H, Dasgupta R, Routh JC, Hawkins DS, Koscielniak E, Bisogno G, Rodeberg DA. Surgical management of paratesticular rhabdomyosarcoma: A consensus opinion from the Children's Oncology Group, European paediatric Soft tissue sarcoma Study Group, and the Cooperative Weichteilsarkom Studiengruppe. Pediatr Blood Cancer 2021; 68:e28938. [PMID: 33522706 PMCID: PMC9019908 DOI: 10.1002/pbc.28938] [Citation(s) in RCA: 17] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/08/2020] [Revised: 12/16/2020] [Accepted: 01/14/2021] [Indexed: 12/14/2022]
Abstract
The treatment of paratesticular rhabdomyosarcoma (PT-RMS) has varied over time and by cooperative group. The International Soft Tissue Sarcoma Database Consortium (INSTRuCT) is a collaboration of the Children's Oncology Group (COG) Soft Tissue Sarcoma Committee, European pediatric Soft tissue sarcoma Study Group (EpSSG), and the Cooperative Weichteilsarkom Studiengruppe (CWS). The INSTRuCT surgical committee has been given charge of the development of internationally applicable consensus guidelines for the surgical treatment of rhabdomyosarcoma. This clinical consensus opinion document addresses accepted principles and areas of controversy, such as scrotal violation and retroperitoneal nodal evaluation, providing an evidence-based guideline for the surgical treatment for PT-RMS.
Collapse
Affiliation(s)
- Timothy N. Rogers
- Department of Paediatric Surgery, University Hospitals Bristol NHS Foundation Trust, Bristol, United Kingdom
| | - Guido Seitz
- Department of Pediatric Surgery, University Hospital Giessen-Marburg, Marburg, Germany
| | - Jörg Fuchs
- Department of Pediatric Surgery and Pediatric Urology, University Children’s Hospital, Hoppe-Seyler-Strasse 1, 72076 Tuebingen, Germany
| | - Helene Martelli
- Department of paediatric surgery, Bicêtre Hospital, Assistance Publique-Hôpitaux de Paris, Hôpitaux Universitaires Paris-Saclay, Le Kremlin Bicêtre, France
| | - Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH USA
| | - Jonathan C. Routh
- Departments of Surgery and Pediatrics, Duke University School of Medicine, Durham, NC, USA
| | - Douglas S. Hawkins
- Division of Hematology/Oncology, Seattle Children’s Hospital, Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA, USA
| | - Ewa Koscielniak
- Klinikum Stuttgart, Zentrum für Kinder-, Jugend-und Frauenmedizin, Olgahospital, Pediatrics 5 (Pediatric Oncology Hematology and Immunology), Kriegsbergstrasse 62, 70174 Stuttgart, Germany
| | - Gianni Bisogno
- Hematology and Oncology Division, Department of Women’s and Children’s Health, Padova University Hospital, Padova, Italy
| | - David A. Rodeberg
- Division Pediatric Surgery, East Carolina University, Greenville, NC, US
| |
Collapse
|
12
|
European guideline for imaging in paediatric and adolescent rhabdomyosarcoma - joint statement by the European Paediatric Soft Tissue Sarcoma Study Group, the Cooperative Weichteilsarkom Studiengruppe and the Oncology Task Force of the European Society of Paediatric Radiology. Pediatr Radiol 2021; 51:1940-1951. [PMID: 34137936 PMCID: PMC8426307 DOI: 10.1007/s00247-021-05081-0] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2021] [Revised: 01/25/2021] [Accepted: 04/14/2021] [Indexed: 02/08/2023]
Abstract
Appropriate imaging is essential in the treatment of children and adolescents with rhabdomyosarcoma. For adequate stratification and optimal individualised local treatment utilising surgery and radiotherapy, high-quality imaging is crucial. The paediatric radiologist, therefore, is an essential member of the multi-disciplinary team providing clinical care and research. This manuscript presents the European rhabdomyosarcoma imaging guideline, based on the recently developed guideline of the European Paediatric Soft Tissue Sarcoma Study Group (EpSSG) Imaging Committee. This guideline was developed in collaboration between the EpSSG Imaging Committee, the Cooperative Weichteilsarkom Studiengruppe (CWS) Imaging Group, and the Oncology Task Force of the European Society of Paediatric Radiology (ESPR). MRI is recommended, at diagnosis and follow-up, for the evaluation of the primary tumour and its relationship to surrounding tissues, including assessment of neurovascular structures and loco-regional lymphadenopathy. Chest CT along with [F-18]2-fluoro-2-deoxyglucose (FDG) positron emission tomography (PET)/CT or PET/MRI are recommended for the detection and evaluation of loco-regional and distant metastatic disease. Guidance on the estimation of treatment response, optimal long-term follow-up, technical imaging settings and standardised reporting are described. This European imaging guideline outlines the recommendations for imaging in children and adolescents with rhabdomyosarcoma, with the aim to harmonise imaging and to advance patient care.
Collapse
|