Paratesticular rhabdomyosarcoma: delayed effects of multimodality therapy and implications for current management

Cancer. 1994 Jan 15;73(2):476-82. doi: 10.1002/1097-0142(19940115)73:2<476::aid-cncr2820730237>;2-n.


Background: The combined modalities of surgery, chemotherapy, and radiation therapy have greatly improved the survival rate in childhood paratesticular rhabdomyosarcoma, but the incidence of complications and late side effects is a cause for concern.

Methods: We reviewed the records of 18 patients treated for paratesticular rhabdomyosarcoma at St. Jude Children's Research Hospital between 1962 and 1989. Patients with Group I disease were treated with orchiectomy, retroperitoneal lymph node dissection, and multi-agent chemotherapy; more advanced cases also received radiation therapy with concurrent chemotherapy.

Results: Sequelae included esophageal and common bile duct stricture, inguinal nerve entrapment syndrome, and small bowel obstruction. Short stature was found in all children whose spines were irradiated via para-aortic fields (34-37 Gy) prior to puberty. Two of 18 patients died from treatment complications and one from progressive disease.

Conclusions: Multimodality treatment offers an excellent prognosis in paratesticular rhabdomyosarcoma, but is associated with significant morbidity and mortality rates. A discussion of therapy components and their application to disease stages suggests possible approaches to optimizing treatment for this therapy-sensitive malignancy.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Adolescent
  • Child
  • Child, Preschool
  • Combined Modality Therapy
  • Humans
  • Lymph Node Excision / adverse effects
  • Male
  • Orchiectomy / adverse effects
  • Prognosis
  • Radiotherapy, High-Energy / adverse effects
  • Rhabdomyosarcoma / mortality
  • Rhabdomyosarcoma / therapy*
  • Testicular Neoplasms / mortality
  • Testicular Neoplasms / therapy*
  • Time Factors