Impact of tumor viability at second-look procedures performed before completing treatment on the Intergroup Rhabdomyosarcoma Study Group protocol IRS-IV, 1991-1997: A report from the children's oncology group

Beverly Raney, Julie Stoner, James Anderson, Richard Andrassy, Carola Arndt, Ken Brown, William Crist, Harold Maurer, Stephen Qualman, Moody Wharam, Eugene Wiener, William Meyer, Andrea Hayes-Jordan

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18 Scopus citations

Abstract

Purposes: The aims of the study were to compare results of clinical/radiographic studies before second-look procedures (SLP) with SLP specimens from patients with gross residual sarcoma at diagnosis and to relate tumor viability to outcome. Patients: Seventy-three patients underwent SLP before completing chemotherapy, with (n = 59) or without (n = 14) radiotherapy. Tumor sites were bladder/prostate (n = 27), head/orbit/parameningeal (n = 22), extremity/trunk (n = 14), and retroperitoneum/pelvis (n = 10). Results: Of 14 patients, 1 (7%) with clinical/radiographic complete response (CR) had viable tumor. Of 59 patients, 35 (59%) without CR had viable tumor. Five-year failure-free survival (FFS) rates were 81% in 37 patients without viable tumor and 53% in 36 patients with viable tumor (Cox proportional hazards adjusted P = .05). Five-year FFS rates were 67% in 15 patients with clear margins and 43% in 21 patients with tumor-involved margins (n = 18) or viable gross tumor (n = 3) (Cox proportional hazards adjusted P = .04). Five-year survival was 78% to 79% among 73 patients with and 333 patients without SLP during treatment. Conclusions: Second-look procedures can show whether viable tumor is present and may be beneficial in selected patients with rhabdomyosarcoma. Disappearance of tumor (CR) usually correlated with no viable tumor at SLP. However, 41% of patients without CR had no viable tumor. Those without viable tumor had increased FFS but not survival compared to those with viable tumor.

Original languageEnglish (US)
Pages (from-to)2160-2168
Number of pages9
JournalJournal of pediatric surgery
Volume45
Issue number11
DOIs
StatePublished - Nov 1 2010

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Keywords

  • Childhood rhabdomyosarcoma
  • IRS-IV protocol
  • Second-look procedures

ASJC Scopus subject areas

  • Surgery
  • Pediatrics, Perinatology, and Child Health

Cite this

Raney, B., Stoner, J., Anderson, J., Andrassy, R., Arndt, C., Brown, K., Crist, W., Maurer, H., Qualman, S., Wharam, M., Wiener, E., Meyer, W., & Hayes-Jordan, A. (2010). Impact of tumor viability at second-look procedures performed before completing treatment on the Intergroup Rhabdomyosarcoma Study Group protocol IRS-IV, 1991-1997: A report from the children's oncology group. Journal of pediatric surgery, 45(11), 2160-2168. https://doi.org/10.1016/j.jpedsurg.2010.07.021