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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, R. Beverly
    Stoner, Julie
    Anderson, James
    Andrassy, Richard
    Arndt, Carola
    Brown, Ken
    Crist, William
    Maurer, Harold
    Qualman, Stephen
    Wharam, Moody
    Wiener, Eugene
    Meyer, William
    Hayes-Jordan, Andrea
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    UMass Chan Affiliations
    Department of Radiation Oncology
    Document Type
    Journal Article
    Publication Date
    2010-11-01
    Keywords
    Antineoplastic Agents
    Child
    Diagnostic Imaging
    Disease-Free Survival
    *Dose Fractionation
    Female
    Follow-Up Studies
    Humans
    Male
    Neoplasm Staging
    Neoplasm, Residual
    Retrospective Studies
    Rhabdomyosarcoma
    Second-Look Surgery
    Survival Rate
    Time Factors
    Treatment Outcome
    United States
    Neoplasms
    Oncology
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    Link to Full Text
    http://dx.doi.org/10.1016/j.jpedsurg.2010.07.021
    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.
    Source
    J Pediatr Surg. 2010 Nov;45(11):2160-8. doi: 10.1016/j.jpedsurg.2010.07.021. Link to article on publisher's site
    DOI
    10.1016/j.jpedsurg.2010.07.021
    Permanent Link to this Item
    http://hdl.handle.net/20.500.14038/47946
    PubMed ID
    21034938
    Notes

    This study was supported in part by Grant CA-29511 from the National Cancer Institute for the IROC Rhode Island (QARC), a quality assurance vehicle and data management service for diagnostic imaging and radiation oncology for the National Cancer Institute Clinical Trials Program. QARC is a research program within the University of Massachusetts Medical School led by Dr. Thomas (TJ) FitzGerald.

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    Link to Article in PubMed
    ae974a485f413a2113503eed53cd6c53
    10.1016/j.jpedsurg.2010.07.021
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