Treatment of Children With Nonmetastatic Paratesticular Rhabdomyosarcoma: Results of the Malignant Mesenchymal Tumors Studies (MMT 84 and MMT 89) of the International Society of Pediatric Oncology
- 1 March 2003
- journal article
- pediatric oncology
- Published by American Society of Clinical Oncology (ASCO) in Journal of Clinical Oncology
- Vol. 21 (5), 793-798
- https://doi.org/10.1200/jco.2003.06.040
Abstract
Purpose: To report the results of the Malignant Mesenchymal Tumors studies (MMT 84 and 89) of the International Society of Pediatric Oncology (SIOP) in males with nonmetastatic paratesticular rhabdomyosarcoma. Patients and Methods: From 1984 to 1994, 96 males were treated in SIOP protocols. Radical inguinal orchidectomy was recommended, but initial retroperitoneal lymph node dissection was not performed. Disease was staged according to the SIOP tumor-node-metastasis staging system. Treatment was stratified by stage. In the MMT 89 study, males with completely resected tumors at diagnosis received less chemotherapy (vincristine and dactinomycin) than patients in the MMT 84 study (ifosfamide, vincristine, and dactinomycin). Results: Median age at diagnosis was 65 months. Thirty-one tumors were larger than 5 cm, and 13 males were older than 10 years with a tumor larger than 5 cm. At a median follow-up of 7 years, 87 patients were alive; 79 were in first complete remission and eight were in second complete remission. Relapse occurred in 16 patients (17%). At 5 years, the overall survival (OS) rate was 92%, with an event-free survival (EFS) rate of 82%. OS and EFS were significantly worse for males with tumors greater than 5 cm and for males older than 10 years at diagnosis. Conclusion: Males with paratesticular RMS have an excellent prognosis except for a selected group of patients older than 10 years or with tumor greater than 5 cm. Intensified chemotherapy incorporating alkylating agents for this subgroup may be preferred to the use of systematic lymphadenectomy to improve survival while minimizing the burden of therapy.This publication has 17 references indexed in Scilit:
- Paratesticular Rhabdomyosarcoma: Report From the Italian and German Cooperative GroupJournal of Clinical Oncology, 2002
- Controversies in the Management of Paratesticular Rhabdomyosarcoma: Is Staging Retroperitoneal Lymph Node Dissection Necessary for Adolescents With Resected Paratesticular Rhabdomyosarcoma?Seminars in Pediatric Surgery, 2001
- Intergroup Rhabdomyosarcoma Study-IV: Results for Patients With Nonmetastatic DiseaseJournal of Clinical Oncology, 2001
- Conservative Treatment for Girls With Nonmetastatic Rhabdomyosarcoma of the Genital Tract: A Report From the Study Committee of the International Society of Pediatric OncologyJournal of Clinical Oncology, 1999
- Treatment of non-metastatic rhabdomyosarcomas in childhood and adolescence. Results of the second study of the International Society of Paediatric Oncology: MMT84European Journal of Cancer, 1998
- Classification of rhabdomyosarcomas and related sarcomas. Pathologic aspects and proposal for a new classification-an intergroup rhabdomyosarcoma studyCancer, 1995
- The Third Intergroup Rhabdomyosarcoma Study.Journal of Clinical Oncology, 1995
- Primary reexcision for patients with ‘microscopic residual’ tumor following initial excision of sarcomas of trunk and extremity sitesJournal of Pediatric Surgery, 1989
- An attempt to use a common staging system in rhabdomyosarcoma: A report of an international workshop initiated by the international society of pediatric oncology (SIOP)Medical and Pediatric Oncology, 1989
- Paraaortic lymphadenectomy is not necessary in the treatment of localized paratesticular rhabdomyosarcomaCancer, 1984