Clinical Perspective on Desmoplastic Small Round-Cell Tumor

Vol. 67, No. 3-4, 2004

Free Abstract Article (Fulltext) Article (PDF 1660 KB)

Clinical Study

Clinical Perspective on Desmoplastic Small Round-Cell Tumor
Alberto Gil^a, Alberto Gomez Portilla^b, Erwin A. Brun^c, Paul H. Sugarbaker^a

^aWashington Cancer Institute, Washington, D.C., USA;
^bDepartment of General Surgery, Hospital Santiago Apostol, Vitoria, Spain;
^cDepartment of Pathology, Washington Hospital Center, Washington, D.C., USA

Address of Corresponding Author

Oncology 2004;67:231-242 (DOI: 10.1159/000081323)

Key Words

Desmoplastic small round-cell tumor
Cytoreductive surgery
Intraperitoneal chemotherapy
Peritoneum
Serosal membranes
Intraperitoneal chemotherapy

Abstract

Rare diseases are often associated with uninformed medical decisions and poorly executed treatments because of inexperience of the physicians. Desmoplastic small round-cell tumor is a rare disease that is a form of peritoneal surface malignancy usually affecting young males, with a mean survival of 29 months. In order to begin to build a more knowledgeable clinical pathway all 7 patients treated at the Washington Hospital Center were studied and compared to patients described in the medical literature. Clinical and pathological data, tumor distribution, cytoreductive surgery, completeness of cytoreduction and survival were recorded and analyzed. The first most common symptoms were pain, increased abdominal girth and palpable abdominal mass in our patients and in the literature review. The overall survival did not improve with cytoreductive surgery plus intraperitoneal chemotherapy (mean survival 32 months); however, 2 long-term survivors who responded to systemic chemotherapy of 55 and 101 months were recorded. The latter may be the longest survivor reported in the literature. No consistent response to chemotherapy was observed in our patients or in any literature review. Complete surgical removal of this malignancy did not correlate with survival in our patients. The absence of improved survival of our aggressively treated patients as compared to the literature was thought to be a consequence of an advanced stage of the disease. A new comprehensive approach that uses complete clearing of cancer by surgery and perioperative systemic and perioperative intraperitoneal chemotherapy as early as is possible in the natural history of the disease emerged as goals for future management.

Author Contacts

Paul H. Sugarbaker, MD
Washington Cancer Institute
110 Irving St., NW
Washington, DC 20010 (USA)
Tel. +1 202 877 3908, Fax +1 202 877 8602, E-Mail Paul.Sugarbaker@medstar.net

Article Information

Received: January 16, 2004
Accepted after revision: April 23, 2004
Number of Print Pages : 12
Number of Figures : 6, Number of Tables : 7, Number of References : 38

Medline Abstract (ID 15557784)

Download Citation

Cited In

This journal is part of the fourth subject package of the Karger

Journal Archive Collection

Information on packages (PDF)
Free sample issues

For non-native English speakers and international authors who would like assistance with their writing before submission, we suggest American Journal Experts for their scientific editing service.