Late effects in 164 patients with rhabdomyosarcoma of the bladder/prostate region: a report from the international workshop.
OBJECTIVE
We determined the late sequelae in children and adolescents with rhabdomyosarcoma of the bladder/prostate treated in the United States, Canada and selected Western European countries, primarily France, Germany, Italy and the United Kingdom, from 1979 to 1998.


METHODS
We used a data collection form to record data from patient records available at the group statistical centers.


RESULTS
A total of 164 patient charts had sufficient data available to be included in the study. Median patient age at diagnosis was 2.4 years. Median length of followup was approximately 8 years (range 3 to 24). Of the patients with available data 78 did not undergo cystectomy, 49 underwent partial cystectomy and 34 underwent complete cystectomy. Urinary continence was assessed at age 6 years or older in 62 patients who did not undergo cystectomy. Of these patients 43 (69%) were continent, 16 had nocturnal incontinence and 9 had diurnal incontinence. Of 44 patients who underwent partial cystectomy and had pertinent followup data 32 (73%) were continent, and 12 had nocturnal and/or diurnal incontinence. Only 11 patients underwent urodynamic investigation. Other nephrourological complications consisted of 3 or more urinary tract infections in 29 of 53 patients, abnormal renal function in 19 of 48 (tubulopathy 14, increased creatinine/blood urea nitrogen 5), chronic hematuria in 13 of 51 and hydronephrosis in 8 of 54 with available data. Vesicoureteral reflux, urinary stones and bowel problems were infrequent.


CONCLUSIONS
Of the patients 48% had a relatively intact bladder after biopsy only. However, 31% of patients 6 years or older had some urinary incontinence, as did 27% of patients who had undergone partial cystectomy. In addition, 55% of all patients had 3 or more urinary tract infections, 40% had decreased renal function and 25% had chronic hematuria. Other complications were present in 15% or less of the patients with available data.
Raney
Beverly
B
Department of Clinical Pediatrics, University of Texas M. D. Anderson Cancer Center, Houston, Texas, USA. beverly.raney@dchstx.org
Anderson
James
J
Jenney
Meriel
M
Arndt
Carola
C
Brecht
Ines
I
Carli
Modesto
M
Bisogno
Gianni
G
Oberlin
Odile
O
Rey
Annie
A
Treuner
Jörn
J
Ullrich
Fred
F
Stevens
Michael
M
D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D006801:Humans; D007223:Infant; D008297:Male; D011471:Prostatic Neoplasms / Q000601:surgery*; D012208:Rhabdomyosarcoma / Q000601:surgery*; D013997:Time Factors; D001749:Urinary Bladder Neoplasms / Q000601:surgery*