Rhabdomyosarcoma surgery
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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 |
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| Head and neck[4] |
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| Extremities[5] |
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| Abdomen or pelvis | Neoadjvant therapy with chemotherapy and radiotherapy; wide local excision |
| 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.