Rhabdomyosarcoma surgery: Difference between revisions
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* In cases with positive margin, re-excision must be done for evaluation. | * In cases with positive margin, re-excision must be done for evaluation. | ||
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| style="padding: 5px 5px; background: #e4e4e4;" | | | style="padding: 5px 5px; background: #e4e4e4;" | Paratesticular region<ref name="pmid24631108">{{cite journal| author=Seitz G, Dantonello TM, Kosztyla D, Klingebiel T, Leuschner I, Fuchs J et al.| title=Impact of hemiscrotectomy on outcome of patients with embryonal paratesticular rhabdomyosarcoma: results from the Cooperative Soft Tissue Sarcoma Group Studies CWS-86, 91, 96 and 2002P. | journal=J Urol | year= 2014 | volume= 192 | issue= 3 | pages= 902-7 | pmid=24631108 | doi=10.1016/j.juro.2014.03.005 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=24631108 }}</ref> | ||
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* Radical inguinal orchiectomy and spermatic cord resection are required. | |||
* Routine ipsilateral nerve-sparing retroperitoneal lymph node dissection (RPLND) is required in boys aged > 10 years old. | |||
* In boys aged < 10 years old, Only excision of present enlarged lymph nodes on radiography is required. | |||
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| style="padding: 5px 5px; background: #e4e4e4;" | Paratesticular region | | style="padding: 5px 5px; background: #e4e4e4;" | Paratesticular region | ||
Revision as of 17:22, 15 February 2019
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Rhabdomyosarcoma Microchapters |
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Treatment |
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Rhabdomyosarcoma surgery On the Web |
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American Roentgen Ray Society Images of Rhabdomyosarcoma surgery |
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Risk calculators and risk factors for Rhabdomyosarcoma surgery |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1];Associate Editor(s)-in-Chief: Suveenkrishna Pothuru, M.B,B.S. [2]
Overview
Surgical resection of the rhabdomyosarcoma is often difficult or impossible because the tumor is usually embedded deep within the tissue, leaving it difficult to reach.
Surgery
- Primary resection of tumor is one of the main prognostic factors in rhabdomyosarcoma.[1][2]
- Based on tumor;s location, surgical resection may be different.
- Findings of surgical resection is essential for risk stratification.
- Surgical tumor resection must contain complete tumor removal with performing safe margin resection.
- Although recommended safety margin is 2 cm, it is impossible to perform in children because of tissue limitation.[3]
- Several biopsies are needed in case of narrow margins to identify residual disease.
- If surgical excision could not be performed, 12 weeks chemotherapy is recommended.
- Lymph nodes need to be assessed for further evaluation.
- In extremities of rhabdomyosarcma, axillary and femoral lymph nodes should be assessed.
| Location | Symptoms |
|---|---|
| Head and neck[4] |
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| Extremities[5][6][7] |
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| Paratesticular region[8] |
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| Paratesticular region | Removal of testes and spermatic cord; ipsilateral retroperitoneal lymphnode resection |
References
- ↑ Schalow EL, Broecker BH (2003). "Role of surgery in children with rhabdomyosarcoma". Med Pediatr Oncol. 41 (1): 1–6. doi:10.1002/mpo.10261. PMID 12764734.
- ↑ PDQ Pediatric Treatment Editorial Board. Childhood Rhabdomyosarcoma Treatment (PDQ®): Health Professional Version. 2019 Jan 29. In: PDQ Cancer Information Summaries [Internet]. Bethesda (MD): National Cancer Institute (US); 2002-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK65802/
- ↑ Dasgupta R, Fuchs J, Rodeberg D (2016). "Rhabdomyosarcoma". Semin Pediatr Surg. 25 (5): 276–283. doi:10.1053/j.sempedsurg.2016.09.011. PMID 27955730.
- ↑ Daya H, Chan HS, Sirkin W, Forte V (2000). "Pediatric rhabdomyosarcoma of the head and neck: is there a place for surgical management?". Arch Otolaryngol Head Neck Surg. 126 (4): 468–72. PMID 10772299.
- ↑ Neville HL, Andrassy RJ, Lobe TE, Bagwell CE, Anderson JR, Womer RB; et al. (2000). "Preoperative staging, prognostic factors, and outcome for extremity rhabdomyosarcoma: a preliminary report from the Intergroup Rhabdomyosarcoma Study IV (1991-1997)". J Pediatr Surg. 35 (2): 317–21. PMID 10693687.
- ↑ Blakely ML, Andrassy RJ, Raney RB, Anderson JR, Wiener ES, Rodeberg DA; et al. (2003). "Prognostic factors and surgical treatment guidelines for children with rhabdomyosarcoma of the perineum or anus: a report of Intergroup Rhabdomyosarcoma Studies I through IV, 1972 through 1997". J Pediatr Surg. 38 (3): 347–53. doi:10.1053/jpsu.2003.50106. PMID 12632347.
- ↑ McMulkin HM, Yanchar NL, Fernandez CV, Giacomantonio C (2003). "Sentinel lymph node mapping and biopsy: a potentially valuable tool in the management of childhood extremity rhabdomyosarcoma". Pediatr Surg Int. 19 (6): 453–6. doi:10.1007/s00383-003-0956-y. PMID 12740706.
- ↑ Seitz G, Dantonello TM, Kosztyla D, Klingebiel T, Leuschner I, Fuchs J; et al. (2014). "Impact of hemiscrotectomy on outcome of patients with embryonal paratesticular rhabdomyosarcoma: results from the Cooperative Soft Tissue Sarcoma Group Studies CWS-86, 91, 96 and 2002P". J Urol. 192 (3): 902–7. doi:10.1016/j.juro.2014.03.005. PMID 24631108.