title: Genitourinary rhabdomyosarcoma: lessons from a developing-world series.
abstract: OBJECTIVE
  The objective was to retrospectively review a large series of pediatric patients with genitourinary rhabdomyosarcoma from a developing country.
  
  
  METHODS
  A total of 49 children were treated over a 47-year period (1961-2008). Analysis of the clinical presentation, demographics, surgical records, histological results, and oncological management was performed. The patients were analyzed as a whole and also in 2 separate groups (pre- and post-1992).
  
  
  RESULTS
  The median age at clinical presentation was 3½ years. The majority (59%) of patients were Intergroup Rhabdomyosarcoma Study group 3, with locally advanced disease at presentation. Twenty (41%) of the 49 patients presented with primary tumors greater than 10 cm in diameter. Sixteen (33%) of the 49 patients had positive regional lymph nodes at presentation. The overall survival of the series was 30 (65%) of 46. The survival for those treated after 1992 in Intergroup Rhabdomyosarcoma Study group 3 was superior (P = .04) to those treated before 1992 (80% vs 56%).
  
  
  CONCLUSIONS
  Children in this large African series of genitourinary rhabdomyosarcoma present with greater locally advanced disease (node positive and bulky disease) when compared with the developed world. Improvements in the last 2 decades in local surgical and oncological care have led to an improvement in survival in children with locally advanced disease.
authors.affiliation: Red Cross Children's Hospital, Paediatric Surgery, Rondebosch 7701, South Africa.
authors.forename: Richard
authors.initials: R
authors.lastname: Wood
authors.forename: John
authors.initials: J
authors.lastname: Lazarus
authors.forename: Alan
authors.initials: A
authors.lastname: Davidson
authors.forename: Angus
authors.initials: A
authors.lastname: Alexander
authors.forename: Alp
authors.initials: A
authors.lastname: Numanoglu
authors.forename: Alistair
authors.initials: A
authors.lastname: Millar
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D003906:Developing Countries; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000175:diagnosis / Q000401:mortality / Q000628:therapy; D013019:South Africa; D015996:Survival Rate; D016896:Treatment Outcome; D014565:Urogenital Neoplasms / Q000175:diagnosis / Q000401:mortality / Q000628:therapy