Epidemiology and survival outcome of adult kidney, bladder, and prostate rhabdomyosarcoma: A SEER database analysis

A Rare Case of Rhabdosarcoma on the Upper Pole of the Kidney

Rhabdomyosarcoma arising from the upper pole of the kidney is an exceedingly rare occurrence, with only a few documented cases reported in the literature. Here, we present a case of a one-year-old Indian male child diagnosed with rhabdomyosarcoma localized to the upper pole of the kidney. The patient presented with abdominal distension persisting for three days, and imaging studies revealed a mass consistent with renal sarcoma. Surgical excision was performed, followed by histopathological examination confirming the diagnosis of rhabdomyosarcoma. Despite aggressive management, the patient's prognosis remains guarded due to the disease's aggressive nature. This case highlights the importance of considering rhabdomyosarcoma in the differential diagnosis of renal masses, particularly in atypical locations. Early diagnosis and a multimodal treatment approach are crucial for optimizing outcomes in such rare cases.

Rhabdomyosarcoma of the urinary bladder in an adult: Case report and review of the literature

Rhabdomyosarcomas with bladder involvement in adults is an extremely rare tumor with approximately 35 cases reported. Because of its rarity in adults the exact treatment modalities are not entirely clear. Treatment is based on Children's Oncology Group in RMS. There is no significant difference in stage, lymph node status, gender, and site between adults and children. The 5 year survival for pediatric RMS is 66% and for adults 22%. It is clear that our understanding and treatment of pediatric RMS is much greater than that of adult patients and the possible reason for these differences are discussed.

Radioresistance in rhabdomyosarcomas: Much more than a question of dose

Management of rhabdomyosarcoma (RMS), the most common soft tissue sarcoma in children, frequently accounting the genitourinary tract is complex and requires a multimodal therapy. In particular, as a consequence of the advancement in dose conformity technology, radiation therapy (RT) has now become the standard therapeutic option for patients with RMS. In the clinical practice, dose and timing of RT are adjusted on the basis of patients' risk stratification to reduce late toxicity and side effects on normal tissues. However, despite the substantial improvement in cure rates, local failure and recurrence frequently occur. In this review, we summarize the general principles of the treatment of RMS, focusing on RT, and the main molecular pathways and specific proteins involved into radioresistance in RMS tumors. Specifically, we focused on DNA damage/repair, reactive oxygen species, cancer stem cells, and epigenetic modifications that have been reported in the context of RMS neoplasia in both in vitro and in vivo studies. The precise elucidation of the radioresistance-related molecular mechanisms is of pivotal importance to set up new more effective and tolerable combined therapeutic approaches that can radiosensitize cancer cells to finally ameliorate the overall survival of patients with RMS, especially for the most aggressive subtypes.

Recurrence and treatment of adult primary nonmetastatic bladder rhabdomyosarcoma: A systematic review

INTRODUCTION

While survival for pediatric bladder rhabdomyosarcoma (RMS) has recently improved with risk-based multimodality treatment protocols, survival for adult bladder RMS remains to be poor. Survival is poor likely because adult bladder RMS is rare, understudied, and consequently lacking in high-level evidence to inform standardization of treatment. In addition, adult bladder RMS exhibits high rates of recurrence. The purpose of this systematic review is to determine associations between patient clinicopathologic factors and recurrence for adult primary bladder RMS, as well as to provide an updated survey of the various treatments employed for this disease in adults.

MATERIAL AND METHODS

Studies involving adult primary bladder RMS were acquired from MEDLINE (OVID), Scopus, and Cochrane Central Register of Controlled Trials from 1947 to 2018. Cases with no metastatic disease at diagnosis and at least 6 months follow-up were included. Multivariable Cox-regression hazard analysis was utilized to determine associations of age, sex, histology, and TNM stage with recurrence. Kaplan-Meier analysis and log-rank testing was used to calculate overall survival (OS) for patients who underwent surgical treatment only, and to evaluate differences in survival between radical cystectomy and partial cystectomy.

RESULTS

20 articles were selected for the review, and 22 cases were obtained. The mean age of the patients was 55.7 ± 18.4 (range = 28-83). With a mean follow-up time of 21.4 ± 18.6 months, 36.4% of the patients experienced disease recurrence. Recurrence was not associated with age, sex, histology, or stage (p = 0.366, p = 0.754, p = 0.889, and p = 0.590, respectively). Most patients underwent surgery only as their initial therapy (n = 12), while the remaining had chemotherapy, radiation, or some combination of these therapies (including surgery). The median OS of patients who underwent surgery only was 21.0 months (95% CI: 0.0-44.6 months). Among these patients, no difference in OS between radical cystectomy and partial cystectomy was found (p = 0.841).

CONCLUSION

Adult bladder RMS is a rare, lethal tumor with a high proclivity for recurrence. No association between age, sex, histology, or stage and recurrence was found. Radical cystectomy is not superior to partial cystectomy in terms of survival, suggesting a role for bladder preservation in select patients. Our study is the first to provide a comprehensive summary of the various treatments employed with clinical outcomes for adult primary bladder RMS.