Ferrari A, Casanova M, Massimino M, Luksch R, Piva L, Fossati-Bellani F
Division of Pediatric Oncology, Istituto Nazionale Tumori, Milano, Italy.
J Urol. 1998 Mar;159(3):1031-4. doi: 10.1016/s0022-5347(01)63830-8.
We report a single institutional experience with 44 consecutive children treated from 1976 to 1996 for paratesticular rhabdomyosarcoma.
After primary surgical excision, 27 cases were classified as Intergroup Rhabdomyosarcoma Study (IRS) group I, 1 as group II, 8 as group III and 8 as group IV. Except for the first 5 patients, retroperitoneal node dissection was not a required staging procedure and was performed only for radiologically suspicious node metastases. Adjuvant chemotherapy was administered to all patients. Additional radiotherapy was given when nodal involvement or residual disease was documented.
The 5-year event-free survival rate was 77% for the entire series of patients, 93% for those in groups I and II, 62.5% in group III and 37.5% in group IV with a median followup of 11 years (range 2 to 20).
Our report confirms the excellent prognosis of localized paratesticular rhabdomyosarcoma. Due to the accuracy of computerized tomography potential morbidity of lymphadenectomy, low rate of retroperitoneal recurrence and presumed efficacy of chemotherapy for controlling microscopic disease, retroperitoneal lymph node dissection seems unnecessary for localized disease.
我们报告了1976年至1996年期间在单一机构连续治疗的44例睾丸旁横纹肌肉瘤患儿的经验。
初次手术切除后，27例被分类为横纹肌肉瘤协作组（IRS）I组，1例为II组，8例为III组，8例为IV组。除前5例患者外，腹膜后淋巴结清扫术并非必需的分期程序，仅在影像学怀疑有淋巴结转移时进行。所有患者均接受辅助化疗。当记录有淋巴结受累或残留疾病时给予额外放疗。
整个系列患者的5年无事件生存率为77%，I组和II组患者为93%，III组为62.5%，IV组为37.5%，中位随访时间为11年（范围2至20年）。
我们的报告证实了局限性睾丸旁横纹肌肉瘤的良好预后。由于计算机断层扫描的准确性、淋巴结切除术的潜在发病率、腹膜后复发率低以及化疗对控制微小疾病的假定疗效，对于局限性疾病，腹膜后淋巴结清扫术似乎没有必要。
