A clinical analysis of rhabdomyosarcoma in the genitourinary tract

Lee, Gil Ho; Cho, Jae Heung

Abstract

The purpose of this study was to assess the effectiveness of chemotherapy in addition to radiation therapy and surgical managements for Rhabdomyosarcoma in genitourinary fields. We have studied 11 cases of rhabdomyosarcoma who admitted to the Department of Urology. Korea University Medical Center, Anam and Kuro Hospital from March 1983 to March 1992 and concluded as follows: 1. 5 patients had prostatic Rhabdomyosarcoma, 4 patients in paratesticular Rhabdomyosarcoma, 1 patient in pelvic cavity and 1 patient in kidney. 2. Various radiologic imaging examinations were done: a. tumor sizes measured by CT scans ranged from 4 x 4 x 3 cm to 13 x 15 x 15 cm. b. paraaortic lymph node enlargement was found only in one patient. 3. According to IRS clinical grouping system, 4 patients belong to the group I ,one in group II. 5 in group m and one in group IV. 4. Grossly complete mass excision was done in 6 patients but it was impossible in another 5 patients due to bulky tumor mass. 5. The histologic classifications were embryonal( 7 patients), alveolar(2 patients) and pleomorphic type (2 patients). 6. 7 of 11 patients did not have adequate treatment: all 7 patients died of disease. The rest 4 patients were adequately treated with our protocol: 3 patients has responsed to prolocol and one patient had failed. 7. 6 of 11 patients treated with various modes of surgery initially such as complete excision of mass(3 patients), nephroureterectomy (one patient), urinary diversion (one patient), radical cystoprostatectomy (one patient)and 5 patients achieved complete remission with surgery for 40, 6. 14, 63 and 32 months, respectively. However 3 of these 5 patients had a local recurrence during the period of follow up: all 3 patients were died of Rhabdomyosarcoma and only 2 of5 patients were still alive without Rhabdomyosarcoma during follow up. 4 of 11 patients initially received pulse VAC chemotherapy, only one patient was achieved a complete remission for 72 months and he is still alive without Rhabdomyosarcoma. 3 patients achieved a partial response for 3, 8, 8 months but all patients died of disease.