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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
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Authors
Raney, BeverlyStoner, Julie
Anderson, James
Andrassy, Richard
Arndt, Carola
Brown, Ken
Crist, William
Maurer, Harold
Qualman, Stephen
Wharam, Moody
Wiener, Eugene
Meyer, William
Hayes-Jordan, Andrea
UMass Chan Affiliations
Quality Assurance Review CenterDocument Type
Journal ArticlePublication Date
2010-11-01
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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.Source
J Pediatr Surg. 2010 Nov;45(11):2160-8. doi: 10.1016/j.jpedsurg.2010.07.021. Link to article on publisher's siteDOI
10.1016/j.jpedsurg.2010.07.021Permanent Link to this Item
http://hdl.handle.net/20.500.14038/46481PubMed ID
21034938Related Resources
Link to Article in PubMedae974a485f413a2113503eed53cd6c53
10.1016/j.jpedsurg.2010.07.021