Treatment and outcome of the patients with rhabdomyosarcoma of the biliary tree: Experience of the Cooperative Weichteilsarkom Studiengruppe (CWS).


Journal

BMC cancer
ISSN: 1471-2407
Titre abrégé: BMC Cancer
Pays: England
ID NLM: 100967800

Informations de publication

Date de publication:
14 Oct 2019
Historique:
received: 11 02 2019
accepted: 20 09 2019
entrez: 16 10 2019
pubmed: 16 10 2019
medline: 27 2 2020
Statut: epublish

Résumé

Biliary rhabdomyosarcoma (RMS) is the most common biliary tumor in children. The management of affected patients contains unique challenges because of the rarity of this tumor entity and its critical location at the porta hepatis, which can make achievement of a radical resection very difficult. In a retrospective chart analysis we analysed children suffering from biliary RMS who were registered in three different CWS trials (CWS-96, CWS-2002P, and SoTiSaR registry). Seventeen patients (12 female, 5 male) with a median age of 4.3 years were assessed. The median follow-up was 42.2 months (10.7-202.5). The 5-year overall (OS) and event free survival (EFS) rates were 58% (45-71) and 47% (34-50), respectively. Patients > 10 years of age and those with alveolar histology had the worst prognosis (OS 0%). Patients with botryoid histology had an excellent survival (OS 100%) compared to those with non-botryoid histology (OS 38%, 22-54, p = 0.047). Microscopic complete tumor resection was achieved in almost all patients who received initial tumor biopsy followed by chemotherapy and delayed surgery. Positive predictive factors for survival of children with biliary RMS are age ≤ 10 years and botryoid tumor histology. Primary surgery with intention of tumor resection should be avoided.

Sections du résumé

BACKGROUND BACKGROUND
Biliary rhabdomyosarcoma (RMS) is the most common biliary tumor in children. The management of affected patients contains unique challenges because of the rarity of this tumor entity and its critical location at the porta hepatis, which can make achievement of a radical resection very difficult.
METHODS METHODS
In a retrospective chart analysis we analysed children suffering from biliary RMS who were registered in three different CWS trials (CWS-96, CWS-2002P, and SoTiSaR registry).
RESULTS RESULTS
Seventeen patients (12 female, 5 male) with a median age of 4.3 years were assessed. The median follow-up was 42.2 months (10.7-202.5). The 5-year overall (OS) and event free survival (EFS) rates were 58% (45-71) and 47% (34-50), respectively. Patients > 10 years of age and those with alveolar histology had the worst prognosis (OS 0%). Patients with botryoid histology had an excellent survival (OS 100%) compared to those with non-botryoid histology (OS 38%, 22-54, p = 0.047). Microscopic complete tumor resection was achieved in almost all patients who received initial tumor biopsy followed by chemotherapy and delayed surgery.
CONCLUSION CONCLUSIONS
Positive predictive factors for survival of children with biliary RMS are age ≤ 10 years and botryoid tumor histology. Primary surgery with intention of tumor resection should be avoided.

Identifiants

pubmed: 31610788
doi: 10.1186/s12885-019-6172-5
pii: 10.1186/s12885-019-6172-5
pmc: PMC6791000
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

945

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Auteurs

Cristian Urla (C)

Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.

Steven W Warmann (SW)

Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany.

Monika Sparber-Sauer (M)

Klinikum Stuttgart, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital, Pediatrics 5 (Pediatric Oncology, Hematology and Immunology), Kreigsbergstrasse 62, 70174, Stuttgart, Germany.

Andreas Schuck (A)

Klinikum Ingolstadt, Prostatakarzinom Zentrum, Krumenauerstraße 25, 85049, Ingolstadt, Germany.

Ivo Leuschner (I)

Department of Pediatric Pathology, University Hospital Schleswig-Holstein, Arnold-Heller-Str. 3/14, 24105, Kiel, Germany.

Thomas Klingebiel (T)

Department of Pediatric Hematology and Oncology, University Hospital Frankfurt, Theodor-Stern-Kai 7, 60590, Frankfurt/Main, Germany.

Gunnar Blumenstock (G)

Department of Clinical Epidemiology and Applied Biometry, University Hospital of Tuebingen, Silcherstraße 5, 72076, Tübingen, Germany.

Guido Seitz (G)

Department of Pediatric Surgery, University Children's Hospital, Baldingerstr, 35043, Marburg, Germany.

Ewa Koscielniak (E)

Klinikum Stuttgart, Zentrum für Kinder-, Jugend- und Frauenmedizin, Olgahospital, Pediatrics 5 (Pediatric Oncology, Hematology and Immunology), Kreigsbergstrasse 62, 70174, Stuttgart, Germany.

Jörg Fuchs (J)

Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Hoppe-Seyler-Strasse 3, 72076, Tübingen, Germany. joerg.fuchs@med.uni-tuebingen.de.

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Classifications MeSH