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Organ preservation in the management of pelvic rhabdomyosarcoma.

The role of exenterative surgical therapy in pelvic rhabdomyosarcoma has been progressively diminishing with the increasing effectiveness of combination chemotherapy. Cooperative studies have demonstrated that, in most instances, the initial surgical procedure should consist of a thorough examination under anesthesia and a biopsy of the mass. Surgery should be repeated to evaluate the therapeutic response to chemotherapy (with or without radiation treatment) so that radical resection, when necessary, is not unduly delayed. In some instances, patients who responded only partially to treatment will, with limited surgical excision, demonstrate a complete response on pathologic examination. The late effects of this multidisciplinary treatment plan must be studied further and long-term follow-up for these children is imperative.