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Pelvic neoplasms in children
1Department of Surgery, Kosair Children's Hospital, Louisville, Kentucky 40202, USA.
Insights
Pediatric pelvic neoplasms require precise diagnosis and tailored treatment. Advances in chemotherapy and surgical techniques have significantly improved survival rates for these rare childhood cancers.
Area of Science:
- Pediatric Oncology
- Surgical Oncology
- Developmental Anatomy
Background:
- Childhood pelvic neoplasms present unique anatomical challenges compared to adults.
- Congenital anomalies of the rectum and bladder influence treatment strategies.
- Common pediatric pelvic tumors include rhabdomyosarcomas, sacrococcygeal teratomas, and germ cell tumors.
Purpose of the Study:
- To highlight the evolving role of surgery in pediatric pelvic neoplasm treatment.
- To emphasize the need for precise histologic and genetic tumor characterization.
- To underscore the importance of multidisciplinary care in specialized children's cancer centers.
Main Methods:
- Review of common pediatric pelvic neoplasms and their characteristics.
- Discussion of advancements in chemotherapy and surgical approaches.
- Analysis of the impact of children's cancer study groups on treatment outcomes.
Main Results:
- Chemotherapy advancements have shifted surgical paradigms towards less radical resections.
- Accurate tumor identification (histologic, genetic, and anatomic) is crucial for effective treatment.
- Survival rates for childhood pelvic neoplasms have dramatically improved over the past two decades.
Conclusions:
- Optimal management of pediatric pelvic neoplasms necessitates specialized care within major children's cancer centers.
- Integrated treatment approaches combining chemotherapy, precise surgery, and genetic analysis are key to improved outcomes.
- The complexity and improved survival rates warrant centralized, expert management for these conditions.
Abstract:
The pelvis of the infant and child has different anatomic relationships than the adolescent or adult pelvis, and the knowledge of congenital anomalies of the rectum and bladder can assist in treating the primary neoplasms of the pelvis. The most common neoplasms are rhabdomyosarcomas of the bladder, prostate, and vagina; sacrococcygeal teratoma; and the germ cell tumors, including teratomas, endodermal sinus tumors, and the choriocarcinomas. Rapidly improving chemotherapy for all of these lesions has resulted in a changed role for the surgeon. Less radical resection of these tumors is being performed whereas it is necessary to have more precise histologic and genetic identification of the tumor and the specific anatomic location and extent of the tumor in the pelvis. Survival for all types of childhood pelvic neoplasms has improved dramatically under the influence of the combined children's cancer study groups, which have been functioning for the last 20 years. Because of the complexities of diagnosis and treatment of these pelvic neoplasms in childhood and because the survival rates have dramatically improved with the most current therapy, these children should be cared for in a children's center that is part of the major children's cancer study groups.
