Skip to main content

Thank you for visiting nature.com. You are using a browser version with limited support for CSS. To obtain the best experience, we recommend you use a more up to date browser (or turn off compatibility mode in Internet Explorer). In the meantime, to ensure continued support, we are displaying the site without styles and JavaScript.

  • Review
  • Published:

Treatment modalities of bladder/prostate rhabdomyosarcoma: a review

Abstract

Treatment outcomes of bladder/prostate rhabdomyosarcoma (RMS) in multi- and single-institutional trials are reviewed. Remarkable strides have occurred in the treatment of this disease. Decreasing duration of chemotherapy, less cumulative doses of radiation therapy, and improving survival have been documented. A focus on bladder preservation has not adversely affected survival in most studies. Even if organ preservation is not possible, improvements in urinary diversion surgical technique still offer improved quality of life. The IRS III was a pivotal study in improving survival and quality of life. We recommend protocol enrollment whenever available. We also emphasize the use of magnetic resonance imaging and second look surgery.

This is a preview of subscription content, access via your institution

Access options

Buy this article

Prices may be subject to local taxes which are calculated during checkout

Figure 1

Similar content being viewed by others

References

  1. Mackenzie AR, Whitmore Jr WF, Melamed MR . Myosarcomas of the bladder and prostate. Cancer 1968; 22: 833–844.

    Article  CAS  Google Scholar 

  2. Lawrence W et al. Embryonal rhabdomyosarcoma. Cancer 1964; 17: 361–376.

    Article  Google Scholar 

  3. Pappo AS et al. Biology and therapy of pediatric rhabdomyosarcoma. J Clin Oncol 1995; 13: 2123–2139.

    Article  CAS  Google Scholar 

  4. Crist W et al. The Third Intergroup Rhabdomyosarcoma Study. J Clin Oncol 1995; 13: 610–630.

    Article  CAS  Google Scholar 

  5. Perez CA . Rhabdomyosarcoma. In: Donaldson SS, Breneman, JC (eds). Principles and Practices of Radiation Oncology, 3rd edn, Lippincott: Baltimore, 1997, 2129–2144.

    Google Scholar 

  6. Arndt CAS, Crist WM . Medical progress: common musculoskeletal tumors of childhood and adolescence. N Eng J Med 1999; 341: 342–352.

    Article  CAS  Google Scholar 

  7. Flamant F, Hill C . The improvement in survival associated with combined chemotherapy in childhood rhabdomyosarcoma. Cancer 1984; 53: 2417–2421.

    Article  CAS  Google Scholar 

  8. Hays DM . et al Bladder and prostatic tumors in the intergroup rhabdomyosarcoma study (IRS-I): results of therapy. Cancer 1982; 50: 1472–1482.

    Article  CAS  Google Scholar 

  9. Ruymann FB, Grovas AC . Progress in the diagnosis and treatment of rhabdomyosarcoma and related soft tissue sarcomas. Cancer Invest 2000; 18: 223–241.

    Article  CAS  Google Scholar 

  10. Tefft M, Jaffe N . Proceedings: sarcoma of the bladder and prostate in children. Rationale for the role of radiation therapy based on a review of the literature and a report of fourteen additional patients. Cancer 1973; 32: 1161–1177.

    Article  CAS  Google Scholar 

  11. Ragab AH et al. Infants younger than 1 year of age with rhabdomyosarcoma. Cancer 1986; 58: 2606–2610.

    Article  CAS  Google Scholar 

  12. Wolden SL et al. Indications for radiotherapy and chemotherapy after complete resection in rhabdomyosarcoma: A report from the Intergroup Rhabdomyosarcoma Studies I to III. J Clin Oncol 1999; 17: 3468–3475.

    Article  CAS  Google Scholar 

  13. Hays DM . Pelvic rhabdomyosarcoma of childhood: diagnosis and concepts of management reviewed. Cancer 1980; 45: 1810–1814.

    Article  CAS  Google Scholar 

  14. Breneman JC, Wiener ES . Issues in the local control of rhabdomyosarcoma. Med Pediatr Oncol 2000; 35:104–109.

    Article  CAS  Google Scholar 

  15. LaQuaglia MP et al. Prognostic factors in bladder and bladder-prostate Rhabdomyosarcoma. J Pediatr Surg 1990; 25: 1066–1072.

    Article  CAS  Google Scholar 

  16. Timmons JW Jr et al. Embryonal rhabdomyosarcoma of the bladder and prostate in childhood. J Urol 1975; 113: 694–697.

    Article  Google Scholar 

  17. Leuschner I et al. Rhabdomyosarcoma of the urinary bladder and vagina. A clinicopathologic study with emphasis on recurrent disease: a report from the Kiel Pediatric Tumor Registry and the German CWS Study. Am J Surg Pathol 2001; 25: 856–864.

    Article  CAS  Google Scholar 

  18. Groff DB . Pelvic neoplasms in children. J Surg Oncol 2001; 77: 65–71.

    Article  CAS  Google Scholar 

  19. Loughlin KR et al. Genitourinary rhabdomyosarcoma in children. Cancer 1989; 63: 1600–1606.

    Article  CAS  Google Scholar 

  20. Hays DM et al. Children with vesical rhabdomyosarcoma (RMS) treated by partial cystectomy with neoadjuvant or adjuvant chemotherapy, with or without radiotherapy. J Pediatr Hematol Onco 195l; 17: 46–52.

    Article  Google Scholar 

  21. McDougal WS, Persky L . Rhabdomyosarcoma of the bladder and prostate in children. J Urol 1980; 124: 882–885.

    Article  CAS  Google Scholar 

  22. Maurer HM et al. The Intergroup Rhabdomyosarcoma Study-I: a Final Report. Cancer 1988; 61: 209–220.

    Article  CAS  Google Scholar 

  23. Maurer HM et al. The Intergroup Rhabdmyosarcoma Study-II. Cancer 1993; 71: 1904–1922.

    Article  CAS  Google Scholar 

  24. Crist WM et al. The Intergroup Rhabdomyosarcoma Study-IV: results for patients with nonmetastatic disease. J Clin Oncol 2001; 19: 3091–3102.

    Article  CAS  Google Scholar 

  25. Donaldson SS et al. Results from the IRS-IV randomized trial of hyperfractionated radiotherapy in children with rhabdomyosarcoma—a report from the IRSG. Int J Radiat Oncol Biol Phys 2001; 51: 718–728.

    Article  CAS  Google Scholar 

  26. Raney B Jr, Heyn R et al. Sequelae of treatment in 109 patients followed for 5 to 15 years after diagnosis of sarcoma of the bladder and prostate A report from the Intergroup Rhabdomyosarcoma Study Committee. Cancer 1993; 71: 2387–2394.

    Article  Google Scholar 

  27. Filipas D . Surgery for urogenital rhabdomyosarcoma. Curr Opin Urol 2001; 11: 563–565.

    Article  CAS  Google Scholar 

  28. Johnson DG. Trends in surgery for childhood rhabdomyosarcoma. Cancer 1975; 35: 916–920.

    Article  CAS  Google Scholar 

  29. Grosfeld JL et al. Rhabdomyosarcoma in childhood: analysis of survival in 98 cases. J Pediatr Surg 1983; 18: 141–146.

    Article  CAS  Google Scholar 

  30. Michaelkiewicz EL et al. Complications of pelvic exenteration in children who have genitourinary rhabdomyosarcoma. J Pediatr Surg 1997; 32: 1277–1282.

    Article  Google Scholar 

  31. Raney Jr RB et al. Primary chemotherapy with or without radiation therapy and/or surgery for children with localized sarcoma of the bladder, prostate, vagina, uterus, and cervix. A comparison of the results in Intergroup Rhabdomyosarcoma Studies I and II. Cancer 1990; 66: 2072–2081.

    Article  Google Scholar 

  32. Lawrence Jr W, Hays DM, Moon TE . Lymphatic metastasis with childhood rhabdomyosarcoma. Cancer 1977; 39: 556–559.

    Article  Google Scholar 

  33. Tefft M et al. Radiation to regional nodes for rhabdomyosarcoma of the genitourinary tract in children: is it necessary? A report from the Intergroup Rhabdomyosarcoma Study No. 1 (IRS-1). Cancer 1980; 45: 3065–3068.

    Article  CAS  Google Scholar 

  34. Hays DM . Bladder/prostate rhabdomyosarcoma: results of the multi-institutional trials of the Intergroup Rhabdomyosarcoma Study. Semin Surg Oncol 1993; 9: 520–523.

    Article  CAS  Google Scholar 

  35. Wharam MD et al. Radiation therapy for rhabdomyosarcoma: local failure risk for clinical group III patients on Intergroup Rhabdomyosarcoma Study II. Int J Radiat Oncol Biol Phys 1995; 38: 797–804.

    Article  Google Scholar 

  36. Green DM . The treatment of advanced or recurrent malignant genitourinary tumors in children. Cancer 1987; 60(Suppl): 602–611.

    Article  CAS  Google Scholar 

  37. Lobe TE et al. The argument for conservative, delayed surgery in the management of prostatic rhabdomyosarcoma. J Pediatr Surg 1996; 31(8): 1084–1087.

    Article  CAS  Google Scholar 

  38. Donaldson SS . The Mandell article reviewed. Oncology 1993; 7: 84–86.

    Google Scholar 

  39. Heyn R et al. Preservation of the bladder in patients with rhabdomyosarcoma. J Clin Oncol 1997; 15: 69–75.

    Article  CAS  Google Scholar 

  40. Ortega JA et al. Presence of well-differentiated rhabdomyoblasts at the end of therapy for pelvic rhabdomyosarcoma: implications for the outcome. J Pediatr Hematol Oncol 2000; 22: 106–111.

    Article  CAS  Google Scholar 

  41. Pappo AS et al. Up-front window of topetecan in previously untreated children and adolescents with metastatic rhabdomyosarcoma: An Intergroup Rhabdomyosarcoma Study. J Clin Oncol 2001; 19: 213–219.

    Article  CAS  Google Scholar 

  42. Koscielnak E et al. Treatment of soft tissue sarcoma in childhood and adolescence. Cancer 1992; 70: 2557–2567.

    Article  Google Scholar 

  43. Koscielnak E et al. Results of treatment for soft tissue sarcoma in childhood and adolescence: a final report of the German Cooperative Soft Tissue Sarcoma Study CWS-86. J Clin Oncol 1999; 17: 3706–3719.

    Article  Google Scholar 

  44. Rodary C et al. Prognostic factors in 281 children with nonmetastatic rhabdomyosarcoma (RMS) at diagnosis. Med Pediatr Oncol 1988; 16: 71–77.

    Article  CAS  Google Scholar 

  45. Flamant F et al. Treatment of non-metastatic rhabdomyosarcoma in childhood and adolescence. Results of the Second Study of the International Society of Paediatric Oncology: MMT 84. Eur J Cancer 1998; 34: 1050–1062.

    Article  CAS  Google Scholar 

  46. Stevens MCG et al. Abstract 142: progress in the treatment of nonmetastatic rhabdomyosarcoma (RMS): A Report From the SIOP MMT 89 and 95 Studies. Med Pediatr Oncol 1999; 33: 177.

    Google Scholar 

  47. El-Sherbiny MT et al. Paediatric lower urinary tract rhabdomyosarcoma: a single-centre experience of 30 patients. BJU Int 2000; 86: 260–267.

    Article  CAS  Google Scholar 

  48. Mugerian PA et al. Outcome analysis of rhabdomyosarcoma of the lower urinary tract. J Urol 1998; 160: 1191–1194.

    Article  Google Scholar 

  49. Duel BP et al. Reconstructive options in genitourinary rhabdomyosarcoma. J Urol 1996; 156: 1798–1804.

    Article  CAS  Google Scholar 

  50. Lerner SP et al. The role of surgery in the management of pediatric pelvic rhabdomyosarcoma. J Urol 1995; 154: 540–545.

    Article  CAS  Google Scholar 

  51. Silvan AM et al. Organ-preserving management of rhabdomyosarcoma of the prostate and bladder in children. Med Pediatr Oncol 1997; 29: 573–575.

    Article  CAS  Google Scholar 

  52. Hicks BA et al. Bladder management in children with genitourinary sarcoma. J Pediatr Surg 1993; 28: 1019–1022.

    Article  CAS  Google Scholar 

  53. Heij HA et al. Urogenital rhabdomyosarcoma in children: is a conservative surgical approach justified? J Urol 1993; 150: 165–168.

    Article  CAS  Google Scholar 

  54. Atra A et al. Conservative surgery in multimodal therapy for pelvic rhabdomyosarcoma in children. Br J Cancer 1994; 70: 1004–1008.

    Article  CAS  Google Scholar 

  55. Verga G, Parigi GB . Conservative surgery of bladder–rostate rhabdomyosarcoma in children: results after long-term follow-up. J Pediatr Surg 1993; 28: 1016–1018.

    Article  CAS  Google Scholar 

  56. Kamii Y et al. Primary chemotherapy for children with rhabdomyosarcoma of the ‘special pelvic’ sites: is preservation of the bladder possible? J Pediatr Surg 1994; 29: 461–464.

    Article  CAS  Google Scholar 

  57. Verga G, Parigi GB . Conservative surgery of bladder–prostate rhabdomyosarcoma in children: results after long-term follow-up. J Pediatr Surg 1993; 28: 1016–1018.

    Article  CAS  Google Scholar 

  58. Flamant F, Hill C . The improvement in survival associated with combined chemotherapy in childhood rhabdomyosarcoma. Cancer 1984; 53: 2417–2421.

    Article  CAS  Google Scholar 

  59. Ortega JA . A therapeutic approach to childhood pelvic rhabdomyosarcoma without pelvic exenteration. J Pediatrics 1979; 94: 205–209.

    Article  CAS  Google Scholar 

  60. Regine WF et al. Local tumor control in rhabdomyosarcoma following low-dose irradiation: comparison of group II and select group III patients. Int J Radiat Oncol Biol Phys 1995; 31: 485–491.

    Article  CAS  Google Scholar 

  61. Nag S et al. Innovation in the management of soft tissue sarcomas in infants and young children: high-dose-rate brachytherapy. J Clin Oncol 1997; 15: 3075–3084.

    Article  CAS  Google Scholar 

  62. Curran WJ, Littman P, Raney RB . Interstitial radiation therapy in the treatment of childhood soft-tissue sarcomas. Int J Radiat Oncol Biol Phys 1988; 14: 169–174.

    Article  Google Scholar 

  63. Rodary C et al. Prognostic factors in 951 nonmetastatic rhabdomyosarcoma in children: a report from the International Rhabdomyosarcoma Workshop. Med Pediatr Oncol 1991; 19: 89–95.

    Article  CAS  Google Scholar 

  64. Koscielnak E et al. Metastatic rhabdomyosarcoma and histologically similar tumors in childhood: a retrospective European multi-center analysis. Med Pediatr Oncol 1992; 20: 209–214.

    Article  Google Scholar 

  65. Shapiro E, Strother D . Pediatric genitourinary rhabdomyosarcoma. J Urol 1992; 148; 1761–1768.

    Article  CAS  Google Scholar 

  66. Donaldson SS et al. Factors that influence treatment decisions in childhood rhabdomyosarcoma. Radiology 1997; 203: 17–22.

    Article  CAS  Google Scholar 

  67. Lawrence W et al. Pretreatment TNM staging of childhood rhabdomyosarcoma. Cancer 1997; 80: 1165–1170.

    Article  Google Scholar 

  68. Kirkwood B . Essentials of Medical Statistics. Blackwell Pub: Oxford, 1988, p 191.

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to P A S Johnstone.

Additional information

The views expressed in this article are ours and do not reflect the official policy or position of the Department of the Navy, Department of Defense, or the United States Government.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Ashlock, R., Johnstone, P. Treatment modalities of bladder/prostate rhabdomyosarcoma: a review. Prostate Cancer Prostatic Dis 6, 112–120 (2003). https://doi.org/10.1038/sj.pcan.4500652

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1038/sj.pcan.4500652

This article is cited by

Search

Quick links