Organ sparing may predispose genitourinary rhabdomyosarcoma patients to extra surgery

Patients with genitourinary rhabdomyosarcoma who undergo organ-sparing treatment have higher odds of additional reconstructive surgery due to compromised urological function, reports a study.

In addition, survey results show poor sexual function for both men and women, although most patients report satisfaction with their urinary function.

A group of researchers identified patients with genitourinary rhabdomyosarcoma of the bladder, prostate, pelvis, vagina, and uterus using records from 1970 to 2018. They evaluated the modes of therapy and, if surgical, the type of resection, reconstruction, and reoperation.

Urinary continence, urinary tract infection occurrence, and stone formation were the primary outcomes. Patients aged >18 years were also surveyed for urinary and sexual function.

Fifty-one patients were included in the post-treatment outcomes cohort, all of whom received chemotherapy, while 46 (90.2 percent) underwent surgery and 34 (67 percent) received radiation. Moreover, 29 patients (56.9 percent) received trimodal therapy, 17 (33.3 percent) chemotherapy/surgery, and five (9.8 percent) chemotherapy/radiation.

Radical surgery, with staged continence mechanism creation, was carried out in 26 patients, who showed higher rates of continence, similar rates of urinary tract infection, and higher rates of stone formation relative to those who were organ-spared. Four of the 12 patients who had organ-sparing treatment went through additional corrective surgery.

A survey was then performed in 30 patients, but only 14 responded to the questionnaires. Overall, urinary complaints were mild, but significant sexual dysfunction was noted in both male and female respondents.

“Multimodal therapy has improved survival in genitourinary rhabdomyosarcoma, a rare paediatric cancer,” the researchers said.