Groff D B
Department of Surgery, Kosair Children's Hospital, Louisville, Kentucky 40202, USA.
J Surg Oncol. 2001 May;77(1):65-71. doi: 10.1002/jso.1068.
The pelvis of the infant and child has different anatomic relationships than the adolescent or adult pelvis, and the knowledge of congenital anomalies of the rectum and bladder can assist in treating the primary neoplasms of the pelvis. The most common neoplasms are rhabdomyosarcomas of the bladder, prostate, and vagina; sacrococcygeal teratoma; and the germ cell tumors, including teratomas, endodermal sinus tumors, and the choriocarcinomas. Rapidly improving chemotherapy for all of these lesions has resulted in a changed role for the surgeon. Less radical resection of these tumors is being performed whereas it is necessary to have more precise histologic and genetic identification of the tumor and the specific anatomic location and extent of the tumor in the pelvis. Survival for all types of childhood pelvic neoplasms has improved dramatically under the influence of the combined children's cancer study groups, which have been functioning for the last 20 years. Because of the complexities of diagnosis and treatment of these pelvic neoplasms in childhood and because the survival rates have dramatically improved with the most current therapy, these children should be cared for in a children's center that is part of the major children's cancer study groups.
婴幼儿的骨盆与青少年或成人的骨盆有着不同的解剖关系，了解直肠和膀胱的先天性异常有助于治疗骨盆原发性肿瘤。最常见的肿瘤是膀胱、前列腺和阴道的横纹肌肉瘤；骶尾部畸胎瘤；以及生殖细胞肿瘤，包括畸胎瘤、内胚窦瘤和绒毛膜癌。针对所有这些病变的化疗迅速改进，导致了外科医生角色的转变。对这些肿瘤进行的根治性切除减少，而有必要对肿瘤进行更精确的组织学和基因鉴定，以及明确肿瘤在骨盆中的具体解剖位置和范围。在过去20年一直发挥作用的儿童癌症联合研究小组的影响下，所有类型的儿童骨盆肿瘤的生存率都有了显著提高。由于儿童骨盆肿瘤诊断和治疗的复杂性，以及最新治疗方法使生存率大幅提高，这些儿童应在作为主要儿童癌症研究小组一部分的儿童中心接受治疗。
