Bladder/Prostate Rhabdomyosarcoma: Past, Present and Future

Purpose

The last few decades have witnessed substantial improvement in outcomes in children with bladder/prostate rhabdomyosarcoma. We reviewed relevant historical aspects of treatment, current treatment strategies and new developments. Most importantly we identified areas of existing controversy, which will provide direction for future studies and continued improvements in therapy.

Materials and Methods

A database (PubMed, MEDLINE, etc) search was performed from 1966 through January 2005. Approximately 500 citations were identified. Relevant citations were reviewed in detail.

Results

While the reported cure rate has improved to approximately 70% to 80% and bladder preservation rates as high as 60% are reported, substantial controversy continues in certain areas. Specifically the long-term function of preserved bladders, the contribution of radiotherapy to bladder dysfunction, the timing of reconstruction and molecular markers of disease progression are among the areas that require further investigation.

Conclusions

Substantial progress has been made as a result of multi-institutional collaborative trials. Future combined studies are required to further the treatment of this childhood malignancy.

Key Words:  bladder , prostate , rhabdomyosarcoma , pediatrics , outcome assessment (health care)

Abbreviations and Acronyms:  ARMS, alveolar rhabdomyosarcoma , B/P, bladder/prostate , COG, Children’s Oncology Group , CT, computerized tomography , ERMS, embryonal rhabdomyosarcoma , IRS, Intergroup Rhabdomyosarcoma Study Group , RMS, rhabdomyosarcoma , RT, radiotherapy , SLO, second look operation , TGF-β, tumor necrosis factor-β , VAC, vincristine, actinomycin D and cyclophosphamide