title: Quality of life and functional outcome of male patients with bladder-prostate rhabdomyosarcoma treated with conservative surgery and brachytherapy during childhood.
abstract: The aim of this study was to report the long-term results of a conservative local treatment of male patients with bladder-prostate rhabdomyosarcoma (BPRMS) focusing on their outcome and quality of life (QoL).
  
  
  
  From 1991 to 2007, 27 male patients were treated by a single team, according to the ongoing European protocols. Surgical procedure was partial cystectomy or partial prostatectomy or both, followed by low-dose-rate interstitial brachytherapy. Three patients died of metastases and two were excluded; 22 patients, who were long-term survivors with their bladder, received a QoL questionnaire derived from the International Workshop on BPRMS. Urodynamic studies were performed when patients had abnormal continence.
  
  
  
  Median age at surgery was 24 months (14 months-11 years). Median followup after surgery was 10 years (5-21 years); 18 male patients (77%) completed the questionnaire at a median age of 13 years (7-25 years); 13 considered themselves as having a normal QoL, with normal urinary continence (9 of 13) or very rare diurnal dribbling (4 of 13). Four male patients had frequent diurnal dribbling requiring protection for three of them and one was submitted to intermittent catheterism for a postoperative neurogenic bladder. Urodynamic studies were performed in 11 patients with urinary disturbance, often revealing detrusor sphincter dyssynergia. All pubertal patients considered themselves as having normal erections. Three sexually active patients reported having satisfying sex and orgasms. Two patients had normal ejaculations.
  
  
  
  The majority of long-term male survivors (76%) within this cohort considered themselves as having a normal QoL after the combined conservative local treatment of their BPRMS.
authors.affiliation: Department of Pediatric Surgery, Bicetre Hospital, Hôpitaux Universitaires Paris Sud, Le Kremlin-Bicetre, France. Electronic address: helene.martelli@aphp.fr.
authors.forename: Hélène
authors.initials: H
authors.lastname: Martelli
authors.affiliation: Department of Pediatric Surgery, CHU de Montpellier, Université de Montpellier 1, Montpellier, France.
authors.forename: Paula
authors.initials: P
authors.lastname: Borrego
authors.affiliation: Department of Pediatric Surgery, Bicetre Hospital, Hôpitaux Universitaires Paris Sud, Le Kremlin-Bicetre, France.
authors.forename: Florent
authors.initials: F
authors.lastname: Guérin
authors.affiliation: Department of Pediatric Surgery, Hôpital La Timone, APHM, Marseille, France.
authors.forename: Julia
authors.initials: J
authors.lastname: Boubnova
authors.affiliation: Department of Pediatric and Adolescent Oncology, Gustave Roussy, Villejuif, France.
authors.forename: Véronique
authors.initials: V
authors.lastname: Minard-Colin
authors.affiliation: Department of Physics, Gustave Roussy, Villejuif, France.
authors.forename: Isabelle
authors.initials: I
authors.lastname: Dumas
authors.affiliation: Department of Brachytherapy, Gustave Roussy, Villejuif, France.
authors.forename: Cyrus
authors.initials: C
authors.lastname: Chargari
authors.affiliation: Department of Brachytherapy, Gustave Roussy, Villejuif, France.
authors.forename: Christine
authors.initials: C
authors.lastname: Haie-Meder
mesh_terms: D000293:Adolescent; D000328:Adult; D000069586:Adult Survivors of Child Adverse Events / Q000523:psychology; D001918:Brachytherapy; D002648:Child; D002675:Child, Preschool; D015653:Cystectomy / Q000379:methods; D004542:Ejaculation; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D059351:Organ Sparing Treatments; D010410:Penile Erection; D011468:Prostatectomy / Q000379:methods; D011471:Prostatic Neoplasms / Q000503:physiopathology / Q000628:therapy*; D011788:Quality of Life; D012208:Rhabdomyosarcoma / Q000503:physiopathology / Q000628:therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome; D001749:Urinary Bladder Neoplasms / Q000503:physiopathology / Q000628:therapy*; D014555:Urination Disorders / Q000209:etiology; D014563:Urodynamics; D055815:Young Adult
keywords: Bladder–prostate rhabdomyosarcoma; Outcome assessment; Pediatrics; Quality of life