Intra-abdominal desmoplastic small round cell tumor: The European pediatric Soft tissue sarcoma Study Group (EpSSG) experience

Pablo Berlanga*, Daniel Orbach, Reineke A. Schoot, Michela Casanova, Rita Alaggio, Nadege Corradini, Bernadette Brennan, Gema L. Ramirez-Villar, Lisa Lyngsie Hjalgrim, Julia C. Chisholm, Gianni Bisogno, Beatrice Coppadoro, Akmal Safwat, Johannes H.M. Merks, Gabriela Guillen Burrieza, Max M. van Noesel, Andrea Ferrari

*Corresponding author for this work

Research output: Contribution to journal/Conference contribution in journal/Contribution to newspaperJournal articleResearchpeer-review

Abstract

Background: This study describes the clinical findings of a consecutive series of pediatric and adolescent patients with a diagnosis of intra-abdominal desmoplastic small round cell tumor (DSRCT) prospectively enrolled in European pediatric Soft tissue sarcoma Study Group (EpSSG) protocols: the BERNIE study, the EpSSG MTS 2008 study, and the EpSSG NRSTS 2005 study. Methods: Patients aged less than 21 years with a diagnosis of DSRCT arising in the abdomen were included. All trials recommended a multimodal approach including intensive multidrug chemotherapy and loco-regional treatment with surgery and/or radiotherapy whenever possible. Results: The analysis included 32 cases (median age 13.7 years, male:female ratio 1.5:1). Three patients had localized tumors, seven had regionally disseminated disease, and 22 extraperitoneal metastases. All but one patient received multidrug chemotherapy and 11 had maintenance chemotherapy. Loco-regional treatment consisted of surgery only in seven cases, surgery plus adjuvant radiotherapy in 10, and radiotherapy only in six. Among the 17 cases who had radiotherapy, six had irradiation of the primary site, 10 had whole abdominopelvic radiotherapy plus boost to macroscopic residual disease, and one had irradiation to lung metastases only. With a median follow-up of 76 months (range: 18–124 months), 5-year event-free and overall survivals were 19.7% and 21.0%, respectively. Event-free survival was significantly worse for patients who did not receive loco-regional treatment (p-value.007). Conclusions: The study confirmed that the outcome of patients with DSRCT remains dismal and did not improve over recent years despite an intensive multimodal treatment approach.

Original languageEnglish
Article numbere30447
JournalPediatric Blood and Cancer
Volume70
Issue9
Number of pages9
ISSN1545-5009
DOIs
Publication statusPublished - Sept 2023

Keywords

  • desmoplastic small round cell tumor
  • EpSSG
  • outcome
  • pediatric
  • treatment

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