Preservation of the bladder in patients with rhabdomyosarcoma

R. Heyn, W. A. Newton, R. B. Raney, A. Hamoudi, C. Bagwell, T. Vietti, M. Wharam, E. Gehan, H. M. Maurer

Research output: Contribution to journalArticle

Abstract

Purpose: To review the pathologic findings from children with gross residual rhabdomyosarcoma (RMS) of the bladder and compare the treatment outcome of those who underwent cystectomy with those who did not. Patients and Methods: Primary and follow-up records and pathology specimens for 28 patients with gross residual disease entered onto the Intergroup Rhabdomyosarcoma Study (IRS) III were reviewed. These patients were assigned to receive 20 weeks of multiagent induction chemotherapy and 4 weeks of radiotherapy. Future therapy decisions were based on clinical and histologic evaluation at 20 weeks. Results: All patients had a clinical and histologic response. Thirteen patients underwent cystectomy at intervals that ranged from 1.5 to 38 months after the start of therapy. All but one patient are alive and well without recurrence. Reasons for cystectomy included presumed evidence of tumor growth from imaging studies, findings at cystoscopy, or histologic interpretation of biopsies. In 12 of 14 specimens from 15 patients who retained their bladder, no tumor cells were seen at first or second evaluation. In cystectomy specimens, tumor cellularity was markedly reduced and all tumor cells were in varying degrees of cellular maturation. Review of primary tumor specimens showed a greater degree of cellular maturation in patients with retained bladders than in those who underwent cystectomy. Conclusion: Bladder RMS is responsive to chemotherapy and radiotherapy. Twelve of 26 patients showed complete loss of tumor cells after induction therapy. Cystectomy specimens showed diminished tumor cells with varying degrees of cellular maturation. It is hypothesized that these tumors may have shown further maturation and ultimate loss of matured cells with continuing therapy.

Original languageEnglish (US)
Pages (from-to)69-75
Number of pages7
JournalJournal of Clinical Oncology
Volume15
Issue number1
StatePublished - Jan 1997
Externally publishedYes

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Rhabdomyosarcoma
Urinary Bladder
Cystectomy
Neoplasms
Radiotherapy
Cystoscopy
Induction Chemotherapy
Therapeutics
Urinary Bladder Neoplasms
Pathology
Biopsy
Recurrence
Drug Therapy

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

Cite this

Heyn, R., Newton, W. A., Raney, R. B., Hamoudi, A., Bagwell, C., Vietti, T., ... Maurer, H. M. (1997). Preservation of the bladder in patients with rhabdomyosarcoma. Journal of Clinical Oncology, 15(1), 69-75.

Preservation of the bladder in patients with rhabdomyosarcoma. / Heyn, R.; Newton, W. A.; Raney, R. B.; Hamoudi, A.; Bagwell, C.; Vietti, T.; Wharam, M.; Gehan, E.; Maurer, H. M.

In: Journal of Clinical Oncology, Vol. 15, No. 1, 01.1997, p. 69-75.

Research output: Contribution to journalArticle

Heyn, R, Newton, WA, Raney, RB, Hamoudi, A, Bagwell, C, Vietti, T, Wharam, M, Gehan, E & Maurer, HM 1997, 'Preservation of the bladder in patients with rhabdomyosarcoma', Journal of Clinical Oncology, vol. 15, no. 1, pp. 69-75.
Heyn R, Newton WA, Raney RB, Hamoudi A, Bagwell C, Vietti T et al. Preservation of the bladder in patients with rhabdomyosarcoma. Journal of Clinical Oncology. 1997 Jan;15(1):69-75.
Heyn, R. ; Newton, W. A. ; Raney, R. B. ; Hamoudi, A. ; Bagwell, C. ; Vietti, T. ; Wharam, M. ; Gehan, E. ; Maurer, H. M. / Preservation of the bladder in patients with rhabdomyosarcoma. In: Journal of Clinical Oncology. 1997 ; Vol. 15, No. 1. pp. 69-75.
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