The role of surgery in children with head and neck rhabdomyosarcoma and Ewing's sarcoma

Rhabdomyosarcoma and Ewing's sarcoma are relatively common malignant tumours in paediatric population. In the past, surgery was the mainstay of treatment and survival rates were poor. Afterwards, the development of multi-agent chemotherapy protocols during the past four decades resulted in a dramatic improvement in long-term survival. As a consequence, the significance of surgery has been the subject of critical discussion in the literature. Nowadays the standard treatment of rhabdomyosarcoma and Ewing's sarcoma consists in a multimodal therapy involving chemotherapy, radiotherapy and surgery. Nevertheless, the role of surgery still remains controversial. In particular, the cure of head and neck localizations presents debatable aspects since defined criteria to establish the risks and the benefits of surgical treatment do not exist at this time. This article reviews the role of surgery in children with head and neck rhabdomyosarcoma and Ewing's sarcoma. Indications, feasibility and timing criteria of surgical treatment have been reviewed and extracted from literature. Our case series is also presented.