The management of paratesticular rhabdomyosarcoma: a single institutional experience with 44 consecutive children.

Abstract

We report a single institutional experience with 44 consecutive children treated from 1976 to 1996 for paratesticular rhabdomyosarcoma. After primary surgical excision, 27 cases were classified as Intergroup Rhabdomyosarcoma Study (IRS) group I, 1 as group II, 8 as group III and 8 as group IV. Except for the first 5 patients, retroperitoneal node dissection was not a required staging procedure and was performed only for radiologically suspicious node metastases. Adjuvant chemotherapy was administered to all patients. Additional radiotherapy was given when nodal involvement or residual disease was documented. The 5-year event-free survival rate was 77% for the entire series of patients, 93% for those in groups I and II, 62.5% in group III and 37.5% in group IV with a median followup of 11 years (range 2 to 20). Our report confirms the excellent prognosis of localized paratesticular rhabdomyosarcoma. Due to the accuracy of computerized tomography potential morbidity of lymphadenectomy, low rate of retroperitoneal recurrence and presumed efficacy of chemotherapy for controlling microscopic disease, retroperitoneal lymph node dissection seems unnecessary for localized disease.