Pediatric radical abdominal trachelectomy for anaplastic embryonal rhabdomyosarcoma of the uterine cervix: an alternative to radical hysterectomy Journal Article

   


Authors: Kayton, M. L.; Wexler, L. H.; Lewin, S.; Park, K. J.; La Quaglia, M. P.; Abu-Rustum, N. R.
Article Title: Pediatric radical abdominal trachelectomy for anaplastic embryonal rhabdomyosarcoma of the uterine cervix: an alternative to radical hysterectomy
Abstract: Rhabdomyosarcoma arising in the female genital tract carries 5-year survival in excess of 80%, but lifelong infertility may be a consequence of local control strategies. We present the technique and outcome for a fertility-sparing, radical abdominal trachelectomy in a 12-year-old girl with anaplastic, embryonal rhabdomyosarcoma involving the uterine cervix. The patient had presented to our center after the piecemeal resection of a uterine cervical mass; because of concern about microscopic residual disease, we classified her as group II-A according to the Intergroup Rhabdomyosarcoma Study system. Staging studies excluded the presence of distant disease. The patient received 4 cycles of multiagent chemotherapy and then underwent radical abdominal trachelectomy, with removal of the uterine cervix, parametria, vaginal cuff, and regional lymph nodes. Microscopically, the specimen showed treatment effect and no residual tumor. Regional nodes were negative. Radical abdominal trachelectomy, which has not been previously reported for rhabdomyosarcoma, has appeared to secure local disease control in this case while preserving the patient's future fertility potential. In properly selected cases of rhabdomyosarcoma of the uterine cervix, where involvement of the uterus proper is not present, radical abdominal trachelectomy may be an attractive fertility-sparing alternative to radical hysterectomy. © 2009 Elsevier Inc. All rights reserved.
Keywords: immunohistochemistry; cancer chemotherapy; child; school child; treatment outcome; surgical technique; case report; chemotherapy, adjuvant; nuclear magnetic resonance imaging; follow-up studies; hysterectomy; neoplasm staging; laparotomy; computer assisted tomography; multiple cycle treatment; tumor volume; antineoplastic combined chemotherapy protocols; combination chemotherapy; cyclophosphamide; vincristine; time factors; risk assessment; minimal residual disease; biopsy, needle; lymph node; dactinomycin; gynecologic surgical procedures; surgical procedures, minimally invasive; cancer control; rhabdomyosarcoma; fertility; uterine cervical neoplasms; gynecologic surgery; uterine cervix tumor; uterus; anaplasia; cervix; embryonal; trachelectomy; anaplastic carcinoma; embryonal rhabdomyosarcoma; radical abdominal trachelectomy; radical hysterectomy; uterine cervix biopsy; uterine cervix cytology; hysteroscopy; infertility, female; rhabdomyosarcoma, embryonal; ultrasonography, doppler
Journal Title: Journal of Pediatric Surgery
Volume: 44
Issue: 4
ISSN: 0022-3468
Publisher: W.B. Saunders Co-Elsevier Inc.  
Date Published: 2009-04-01
Start Page: 862
End Page: 867
Language: English
DOI: 10.1016/j.jpedsurg.2008.11.038
PUBMED: 19361657
PROVIDER: scopus
PMCID: PMC4989909
DOI/URL:

http://www.scopus.com/inward/record.url?eid=2-s2.0-63649136539&partnerID=40&md5=9ec2398f47d951783c7163dd8f10fedc
Notes: --- - "Cited By (since 1996): 1" - "Export Date: 30 November 2010" - "CODEN: JPDSA" - "Source: Scopus"
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MSK Authors
  1. Michael P La Quaglia
    412 La Quaglia
  2. Leonard H Wexler
    192 Wexler
  3. Nadeem Abu-Rustum
    890 Abu-Rustum
  4. Mark Lawrence Kayton
    19 Kayton
  5. Kay Jung Park
    308 Park
  6. Sharyn Nan Lewin
    16 Lewin
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