Skip to main content
Journal cover image

Local therapy for rhabdomyosarcoma of the hands and feet: is amputation necessary? A report from the Children's Oncology Group.

Publication ,  Journal Article
La, TH; Wolden, SL; Su, Z; Linardic, C; Randall, RL; Hawkins, DS; Donaldson, SS
Published in: Int J Radiat Oncol Biol Phys
May 1, 2011

PURPOSE: To evaluate the outcome of children with rhabdomyosarcoma (RMS) of the hand or foot treated with surgery and/or local radiotherapy (RT). METHODS AND MATERIALS: Forty-eight patients with nonmetastatic RMS of the hand or foot were enrolled on Intergroup Rhabdomyosarcoma Study III, IV-Pilot, and IV. Patients received multiagent chemotherapy with surgery and/or RT. Twenty-four patients (50%) underwent surgery without local RT, of whom 4 had complete resection and 20 had an amputation. The remaining 24 patients (50%) underwent local RT, of whom 2 required RT for microscopic residual disease after prior amputation. Median follow-up for surviving patients was 9.7 years. RESULTS: Actuarial 10-year local control was 100%; 10-year event-free survival and overall survival rates were 62% and 63%, respectively. Poor prognostic factors for recurrence included gross residual (Group III) disease and nodal involvement (p = 0.01 and 0.05, respectively). More patients in the RT group had alveolar histology, Group III disease, and nodal involvement, as compared with the surgery group. There was no difference in 10-year event-free survival (57% vs. 66%) or overall survival (63% vs. 63%) between patients who underwent surgery or local RT. Among relapsing patients, there were no long-term survivors. No secondary malignancies have been observed. CONCLUSIONS: Despite having high-risk features, patients treated with local RT achieved excellent local control. Complete surgical resection without amputation is difficult to achieve in the hand or foot. Therefore, we recommend either definitive RT or surgical resection that maintains form and function as primary local therapy rather than amputation in patients with hand or foot RMS.

Duke Scholars

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

May 1, 2011

Volume

80

Issue

1

Start / End Page

206 / 212

Location

United States

Related Subject Headings

  • Young Adult
  • Survival Rate
  • Rhabdomyosarcoma
  • Radiotherapy Dosage
  • Oncology & Carcinogenesis
  • Neoplasm, Residual
  • Neoplasm Recurrence, Local
  • Lymph Nodes
  • Humans
  • Hand
 

Citation

APA
Chicago
ICMJE
MLA
NLM
La, T. H., Wolden, S. L., Su, Z., Linardic, C., Randall, R. L., Hawkins, D. S., & Donaldson, S. S. (2011). Local therapy for rhabdomyosarcoma of the hands and feet: is amputation necessary? A report from the Children's Oncology Group. Int J Radiat Oncol Biol Phys, 80(1), 206–212. https://doi.org/10.1016/j.ijrobp.2010.01.053
La, Trang H., Suzanne L. Wolden, Zheng Su, Corinne Linardic, R Lor Randall, Douglas S. Hawkins, and Sarah S. Donaldson. “Local therapy for rhabdomyosarcoma of the hands and feet: is amputation necessary? A report from the Children's Oncology Group.Int J Radiat Oncol Biol Phys 80, no. 1 (May 1, 2011): 206–12. https://doi.org/10.1016/j.ijrobp.2010.01.053.
La TH, Wolden SL, Su Z, Linardic C, Randall RL, Hawkins DS, et al. Local therapy for rhabdomyosarcoma of the hands and feet: is amputation necessary? A report from the Children's Oncology Group. Int J Radiat Oncol Biol Phys. 2011 May 1;80(1):206–12.
La, Trang H., et al. “Local therapy for rhabdomyosarcoma of the hands and feet: is amputation necessary? A report from the Children's Oncology Group.Int J Radiat Oncol Biol Phys, vol. 80, no. 1, May 2011, pp. 206–12. Pubmed, doi:10.1016/j.ijrobp.2010.01.053.
La TH, Wolden SL, Su Z, Linardic C, Randall RL, Hawkins DS, Donaldson SS. Local therapy for rhabdomyosarcoma of the hands and feet: is amputation necessary? A report from the Children's Oncology Group. Int J Radiat Oncol Biol Phys. 2011 May 1;80(1):206–212.
Journal cover image

Published In

Int J Radiat Oncol Biol Phys

DOI

EISSN

1879-355X

Publication Date

May 1, 2011

Volume

80

Issue

1

Start / End Page

206 / 212

Location

United States

Related Subject Headings

  • Young Adult
  • Survival Rate
  • Rhabdomyosarcoma
  • Radiotherapy Dosage
  • Oncology & Carcinogenesis
  • Neoplasm, Residual
  • Neoplasm Recurrence, Local
  • Lymph Nodes
  • Humans
  • Hand