Adult genitourinary sarcoma: The 25-year Memorial Sloan-Kettering experience Journal Article

Authors: Dotan, Z. A.; Tal, R.; Golijanin, D.; Snyder, M. E.; Antonescu, C.; Brennan, M. F.; Russo, P.
Article Title: Adult genitourinary sarcoma: The 25-year Memorial Sloan-Kettering experience
Abstract: Purpose: Urological sarcomas are rare. We describe a continued single institutional experience during 25 years. Materials and Methods: The records from July 1977 to July 2003 were reviewed of all patients at our institution with sarcoma arising in the urinary tract or male genital system who were 16 years or older at diagnosis. Results: The primary tumor site in 131 patients was the bladder in 20, the kidney in 26, paratesticular in 57, the prostate in 21 and other in 7. Median followup was 4.0 years. The most common histological subtypes were leiomyosarcoma in 29% of cases and liposarcoma in 26%. Median tumor size was 7 cm and 78% of lesions were high grade. Of the patients 28 (21%) presented with metastatic disease and their median survival was 1.4 years compared to 10.7 years in patients without metastatic disease (p <0.0001). Disease specific survival was 56% and 42% at 5 and 10 years, respectively and median survival was 7.6 years. On univariate analysis unfavorable prognostic variables for disease specific survival were metastasis at presentation, high tumor grade, a lack of leiomyosarcoma and liposarcoma histological subtypes, prostate sarcoma and large tumor size, incomplete surgical resection and positive surgical margin. Patient sex, age and surgical margin status were not significant predictors. On multivariate analysis 2 variables remained significant predictors of disease specific survival, including tumor size (HR 1.1, 95% CI 1.02 to 1.17) and absent metastasis at diagnosis (HR 4.9, 95% CI 1.4 to 17.2). Conclusions: Predictors of disease specific survival include local disease at presentation, complete tumor resection and tumor grade, size, location and histological subtype. With adequate surgical treatment most patients who presented with primary disease and underwent complete surgical resection achieved prolonged disease specific survival. © 2006 American Urological Association.
Keywords: adolescent; adult; cancer survival; aged; aged, 80 and over; disease-free survival; middle aged; cancer surgery; survival rate; major clinical study; histopathology; cancer localization; disease free survival; cancer grading; prospective studies; metastasis; neoplasm recurrence, local; tumor volume; medical record review; bladder cancer; urogenital tract cancer; time factors; prostate cancer; sarcoma; urogenital neoplasms; survival time; urinary tract cancer; neoplasm metastasis; multivariate analysis; cancer classification; leiomyosarcoma; testis cancer; univariate analysis; liposarcoma; rare disease; male genital tract cancer; kidney sarcoma
Journal Title: Journal of Urology
Volume: 176
Issue: 5
ISSN: 0022-5347
Publisher: Elsevier Science, Inc.  
Date Published: 2006-11-01
Start Page: 2033
End Page: 2039
Language: English
DOI: 10.1016/j.juro.2006.07.021
PUBMED: 17070247
PROVIDER: scopus
Notes: --- - "Cited By (since 1996): 37" - "Export Date: 4 June 2012" - "CODEN: JOURA" - "Source: Scopus"
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MSK Authors
  1. Zohar A Dotan
    19 Dotan
  2. Murray F Brennan
    759 Brennan
  3. Paul Russo
    446 Russo
  4. Cristina R Antonescu
    606 Antonescu
  5. Raanan Tal
    45 Tal
  6. Mark Snyder
    26 Snyder