Bladder management in children with genitourinary sarcoma

Barry A. Hicks, Terry W. Hensle, Kevin A. Burbige, R. Peter Altman

Research output: Contribution to journalArticle

15 Citations (Scopus)

Abstract

Between 1977 and 1991, 14 patients were treated for genitourinary sarcoma (mean age, 7.4 years). The primary site was bladder in six patients, prostate in five, and vagina in three. Histological study showed embryonal rhabdomyosarcoma in 12 and leiomyosarcoma in 2 children. Initial therapy included biopsy followed by chemotherapy in all patients. Subsequently, five patients had anterior exenteration, four underwent partial cystectomy, and one patient had a radical prostatectomy; four patients were treated with chemotherapy and external beam pelvic irradiation (4,000 to 6,000 rads) alone. Overall survival for the group is 100% (follow-up 6 to 168 months). Two of four patients undergoing partial cystectomy had bladder augmentation at the time of surgery. All patients having partial cystectomy had negative surgical margins, are tumor free, and have volitional voiding. Two of four patients (50%) initially treated with chemotherapy and radiotherapy alone have had significant bladder deterioration requiring bladder reconstruction. There has been an evolution toward less radical, initial surgical intervention in pediatric genitourinary sarcoma; however, surgical resection continues to be the primary curative modality. Partial cystectomy with or without primary reconstruction may be preferable to exenteration for selected patients. Primary reconstruction at the time of partial cystectomy leaves a functional bladder and excellent long-term results. Children treated with chemotherapy and radiotherapy protocols alone must be monitored for late bladder deterioration.

Original languageEnglish (US)
Pages (from-to)1019-1022
Number of pages4
JournalJournal of Pediatric Surgery
Volume28
Issue number8
DOIs
StatePublished - Jan 1 1993

Fingerprint

Sarcoma
Urinary Bladder
Cystectomy
Drug Therapy
Radiotherapy
Embryonal Rhabdomyosarcoma
Leiomyosarcoma
Vagina
Prostatectomy
Prostate
Pediatrics
Biopsy
Survival

Keywords

  • genitourinary
  • Sarcoma

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Surgery

Cite this

Bladder management in children with genitourinary sarcoma. / Hicks, Barry A.; Hensle, Terry W.; Burbige, Kevin A.; Peter Altman, R.

In: Journal of Pediatric Surgery, Vol. 28, No. 8, 01.01.1993, p. 1019-1022.

Research output: Contribution to journalArticle

Hicks, Barry A. ; Hensle, Terry W. ; Burbige, Kevin A. ; Peter Altman, R. / Bladder management in children with genitourinary sarcoma. In: Journal of Pediatric Surgery. 1993 ; Vol. 28, No. 8. pp. 1019-1022.
@article{c918b4e99e194c3595c50add19e862bc,
title = "Bladder management in children with genitourinary sarcoma",
abstract = "Between 1977 and 1991, 14 patients were treated for genitourinary sarcoma (mean age, 7.4 years). The primary site was bladder in six patients, prostate in five, and vagina in three. Histological study showed embryonal rhabdomyosarcoma in 12 and leiomyosarcoma in 2 children. Initial therapy included biopsy followed by chemotherapy in all patients. Subsequently, five patients had anterior exenteration, four underwent partial cystectomy, and one patient had a radical prostatectomy; four patients were treated with chemotherapy and external beam pelvic irradiation (4,000 to 6,000 rads) alone. Overall survival for the group is 100{\%} (follow-up 6 to 168 months). Two of four patients undergoing partial cystectomy had bladder augmentation at the time of surgery. All patients having partial cystectomy had negative surgical margins, are tumor free, and have volitional voiding. Two of four patients (50{\%}) initially treated with chemotherapy and radiotherapy alone have had significant bladder deterioration requiring bladder reconstruction. There has been an evolution toward less radical, initial surgical intervention in pediatric genitourinary sarcoma; however, surgical resection continues to be the primary curative modality. Partial cystectomy with or without primary reconstruction may be preferable to exenteration for selected patients. Primary reconstruction at the time of partial cystectomy leaves a functional bladder and excellent long-term results. Children treated with chemotherapy and radiotherapy protocols alone must be monitored for late bladder deterioration.",
keywords = "genitourinary, Sarcoma",
author = "Hicks, {Barry A.} and Hensle, {Terry W.} and Burbige, {Kevin A.} and {Peter Altman}, R.",
year = "1993",
month = "1",
day = "1",
doi = "10.1016/0022-3468(93)90507-H",
language = "English (US)",
volume = "28",
pages = "1019--1022",
journal = "Journal of Pediatric Surgery",
issn = "0022-3468",
publisher = "W.B. Saunders Ltd",
number = "8",

}

TY - JOUR

T1 - Bladder management in children with genitourinary sarcoma

AU - Hicks, Barry A.

AU - Hensle, Terry W.

AU - Burbige, Kevin A.

AU - Peter Altman, R.

PY - 1993/1/1

Y1 - 1993/1/1

N2 - Between 1977 and 1991, 14 patients were treated for genitourinary sarcoma (mean age, 7.4 years). The primary site was bladder in six patients, prostate in five, and vagina in three. Histological study showed embryonal rhabdomyosarcoma in 12 and leiomyosarcoma in 2 children. Initial therapy included biopsy followed by chemotherapy in all patients. Subsequently, five patients had anterior exenteration, four underwent partial cystectomy, and one patient had a radical prostatectomy; four patients were treated with chemotherapy and external beam pelvic irradiation (4,000 to 6,000 rads) alone. Overall survival for the group is 100% (follow-up 6 to 168 months). Two of four patients undergoing partial cystectomy had bladder augmentation at the time of surgery. All patients having partial cystectomy had negative surgical margins, are tumor free, and have volitional voiding. Two of four patients (50%) initially treated with chemotherapy and radiotherapy alone have had significant bladder deterioration requiring bladder reconstruction. There has been an evolution toward less radical, initial surgical intervention in pediatric genitourinary sarcoma; however, surgical resection continues to be the primary curative modality. Partial cystectomy with or without primary reconstruction may be preferable to exenteration for selected patients. Primary reconstruction at the time of partial cystectomy leaves a functional bladder and excellent long-term results. Children treated with chemotherapy and radiotherapy protocols alone must be monitored for late bladder deterioration.

AB - Between 1977 and 1991, 14 patients were treated for genitourinary sarcoma (mean age, 7.4 years). The primary site was bladder in six patients, prostate in five, and vagina in three. Histological study showed embryonal rhabdomyosarcoma in 12 and leiomyosarcoma in 2 children. Initial therapy included biopsy followed by chemotherapy in all patients. Subsequently, five patients had anterior exenteration, four underwent partial cystectomy, and one patient had a radical prostatectomy; four patients were treated with chemotherapy and external beam pelvic irradiation (4,000 to 6,000 rads) alone. Overall survival for the group is 100% (follow-up 6 to 168 months). Two of four patients undergoing partial cystectomy had bladder augmentation at the time of surgery. All patients having partial cystectomy had negative surgical margins, are tumor free, and have volitional voiding. Two of four patients (50%) initially treated with chemotherapy and radiotherapy alone have had significant bladder deterioration requiring bladder reconstruction. There has been an evolution toward less radical, initial surgical intervention in pediatric genitourinary sarcoma; however, surgical resection continues to be the primary curative modality. Partial cystectomy with or without primary reconstruction may be preferable to exenteration for selected patients. Primary reconstruction at the time of partial cystectomy leaves a functional bladder and excellent long-term results. Children treated with chemotherapy and radiotherapy protocols alone must be monitored for late bladder deterioration.

KW - genitourinary

KW - Sarcoma

UR - http://www.scopus.com/inward/record.url?scp=0027313226&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0027313226&partnerID=8YFLogxK

U2 - 10.1016/0022-3468(93)90507-H

DO - 10.1016/0022-3468(93)90507-H

M3 - Article

VL - 28

SP - 1019

EP - 1022

JO - Journal of Pediatric Surgery

JF - Journal of Pediatric Surgery

SN - 0022-3468

IS - 8

ER -