Annals of Surgical Oncology

, Volume 5, Issue 5, pp 416–422

Desmoplastic small round cell tumors: Prognostic indicators and results of surgical management

  • Roderich E. Schwarz
  • William L. Gerald
  • Brian H. Kushner
  • Daniel G. Coit
  • Murray F. Brennan
  • Michael P. La Quaglia
Original Articles

DOI: 10.1007/BF02303860

Cite this article as:
Schwarz, R.E., Gerald, W.L., Kushner, B.H. et al. Annals of Surgical Oncology (1998) 5: 416. doi:10.1007/BF02303860

Abstract

Background: Desmoplastic small round cell tumors (DSRCT or DSCT) are rare aggressive cancers of adolescence and early adulthood. There are few reported series to guide clinical therapy. This study correlates survival with treatment variables, including aggressive surgical debulking.

Methods: Thirty-two patients with documented DSRCT received treatment at our institution. Demographic, clinical, and treatment variables were correlated with progression-free survival using log-rank statistics.

Results: Thirty patients were male (96%), and two were female (4%), with a median age at diagnosis of 22 years. The primary site of disease in 97% of cases was the abdomen or pelvis. Twenty-nine patients (91%) had extensive disease involving peritoneal surfaces, lymph nodes, or discontinuous organs. All 32 patients received systemic chemotherapy. Fifteen (47%) underwent tumor debulking greater than 90% at diagnosis or during therapy. A complete or very good response to therapy occurred in 13 patients, and depended on surgical removal of bulk disease in all. Thirteen patients remained progression-free, but three of these patients died from treatment toxicity. Improved survival was correlated with a complete or very good partial response to multimodality therapy, surgical debulking of more than 90% either before or after chemotherapy, and use of the P6 protocol.

Conclusions: DSRCT is an aggressive cancer that occurs predominantly in young males. Improved survival is correlated with intense chemotherapy and aggressive resection.

Key Words

Desmoplastic small round cell tumor Chemotherapy Resection Surgery 

Copyright information

© The Society of Surgical Oncology, Inc. 1998

Authors and Affiliations

  • Roderich E. Schwarz
    • 3
  • William L. Gerald
    • 1
  • Brian H. Kushner
  • Daniel G. Coit
    • 3
  • Murray F. Brennan
    • 3
  • Michael P. La Quaglia
    • 3
  1. 1.the Department of PathologyMemorial Sloan-Kettering Cancer CenterNew York
  2. 2.the Department of General Oncologic SurgeryCity of Hope National Medical CenterDuarte
  3. 3.Dept. of SurgeryMemorial Sloan-Kettering Cancer CenterNew York

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