Role of Surgical Resection in Adult Urological Soft Tissue Sarcoma: 25-Year Experience

Abstract

Introduction: As adult urological soft tissue sarcomas (STS) are rare, there have been few recent large-scale studies of these tumors. This report describes a single institutional experience of adult urological STS over 25 years. Patients and Methods: The study population consisted of 25 adult patients with histologically diagnosed STS arising in the urinary tract, male genital system, or retroperitoneum between January 1983 and July 2008. The study endpoint was overall survival. The crude probability of survival was estimated using the Kaplan-Meier method. Uni- and multivariate analysis of differences between patient groups was performed with the log rank test and the Cox proportional hazards model. Results: Overall survival rate at 5 years was 54.2%. On univariate analysis, unfavorable prognostic variables for overall survival were presence of metastasis at diagnosis (p = 0.0005), absence of surgical resection (p = 0.0003), histological subtype of rhabdomyosarcoma (p = 0.0068), and primary organs other than retroperitoneum (p = 0.0410). On multivariate analysis, absence of surgical resection remained a significant predictor of unfavorable prognosis (HR 2.67, 95% CI 1.03–7.76, p = 0.044). Conclusions: Surgical resection, regardless of status of surgical resection margin, contributed to a favorable prognosis in adult patients with locally advanced or metastatic urological STS.

Adult genitourinary sarcoma: Clinical characteristics and survival in a series of patients treated at a high‐volume institution

“…Because of the rarity, even in large institutions it is difficult to accumulate sufficient cases to delineate the clinicopathological characteristics of adult genitourinary sarcoma, and draw conclusions on predictors of OS, RFS and MFS. Table summarizes six clinical series on adult genitourinary sarcoma and provides comparisons with the present study . To the best of our knowledge, our series (188 adult cases over a 25‐year period) represents the largest cohort of adult genitourinary sarcoma worldwide.…”

“…Table 3 summarizes six clinical series on adult genitourinary sarcoma and provides comparisons with the present study. 2,3,[11][12][13][14] To the best of our knowledge, our series (188 adult cases over a 25-year period) represents the largest cohort of adult genitourinary sarcoma worldwide. The median age at diagnosis in our patients was 42 years, much younger than previous series (range 47.1-61 years).…”

Adult prostatic sarcoma: A contemporary multicenter Rare Cancer Network study

“…Prostatic sarcoma (PS) is an extremely rare type of adult non‐epithelial malignant tumor, accounting for only 0.1‐0.2% of all prostate cancers . Surgery is considered the standard therapeutic cornerstone, similar to the approach for other sarcomas. However, surgery alone seems to obtain poor results when compared to multidisciplinary approaches .…”

Prognostic Factors and Clinical Outcomes of Urological Soft Tissue Sarcomas

“…STSs of the genitourinary (GU) tract are relatively rare, accounting for only 2.1% of all STSs and 1% to 2% of all malignant GU tumors [1-3]. Because of the rarity of urological STSs, clinical data are limited and prognosis is often considered unpredictable [4,5]. Recently, several groups have reported their long-term experiences with GU STSs and have investigated prognosis and prognostic factors [4-6].…”

“…Because of the rarity of urological STSs, clinical data are limited and prognosis is often considered unpredictable [4,5]. Recently, several groups have reported their long-term experiences with GU STSs and have investigated prognosis and prognostic factors [4-6]. Although the consensus is that total surgical resection provides the patient the best chance for cure [2,7], there is no universal agreement concerning prognostic factors for GU STSs.…”