Smeulders N, Gaze MN, Guérin F, Rogers T, Terwisscha van Scheltinga S, DeCorti F, Chisholm J, Slater O, Minard-Colin V, Coppadoro B, Zanetti I, Craigie R, Burrieza GG, Dall'Igna P, Fajardo RD, Lim P, Chargari C, Espenel S, Luis Huertas AL, Cho A, Nguyen T, Rees H, Bisogno G, Merks JHM, Martelli H.
J Pediatr Surg. 2026 Jul;61(7):163162. doi: 10.1016/j.jpedsurg.2026.163162. Epub 2026 Apr 27.PMID: 42055245
Children with bladder or prostate rhabdomyosarcoma (BP-RMS) need careful staging to determine whether the cancer has spread to nearby lymph nodes, as this helps guide treatment. While removing and examining lymph nodes under a microscope is important for some types of rhabdomyosarcoma, its value in BP-RMS has been unclear.
This study examined how lymph node staging was performed and whether it affected outcomes in 224 children with BP-RMS treated in international clinical trials. Most children had their lymph nodes assessed using imaging scans rather than surgery. Even when surgery was performed, lymph nodes were often not removed for testing. In some children, surgical assessment found cancer that scans had missed or showed that suspicious lymph nodes seen on scans did not contain cancer. This led doctors to change treatment in some cases.
However, overall, children who had surgical lymph node assessment did not have better survival or a lower risk of the cancer returning compared with those whose lymph nodes were assessed using imaging alone. This was also true for children who were at higher risk because of their age or tumour type. Treating the lymph node areas with radiotherapy also did not improve outcomes.
These findings suggest that, unlike other forms of rhabdomyosarcoma, routine surgical sampling of lymph nodes may not improve outcomes for children with bladder or prostate rhabdomyosarcoma, although it can provide additional information that may influence treatment decisions in individual patients.
This study examined how lymph node staging was performed and whether it affected outcomes in 224 children with BP-RMS treated in international clinical trials. Most children had their lymph nodes assessed using imaging scans rather than surgery. Even when surgery was performed, lymph nodes were often not removed for testing. In some children, surgical assessment found cancer that scans had missed or showed that suspicious lymph nodes seen on scans did not contain cancer. This led doctors to change treatment in some cases.
However, overall, children who had surgical lymph node assessment did not have better survival or a lower risk of the cancer returning compared with those whose lymph nodes were assessed using imaging alone. This was also true for children who were at higher risk because of their age or tumour type. Treating the lymph node areas with radiotherapy also did not improve outcomes.
These findings suggest that, unlike other forms of rhabdomyosarcoma, routine surgical sampling of lymph nodes may not improve outcomes for children with bladder or prostate rhabdomyosarcoma, although it can provide additional information that may influence treatment decisions in individual patients.
