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Adult primary prostate sarcoma: A multi-center cohort study and comparison between Chinese and American cases
Beichen Ding1, Yucong Zhang2, Wei Hu3
1Department of Urology, Tongji Hospital, Tongji Medical College, Huazhong, University of Science and Technology, Wuhan, 430030, China; Department of Urology Surgery, The First Affiliated Hospital of Harbin Medical University, Harbin, 15001, China.
Background/Objectives:
To assess the effects of clinical factors and treatments on the overall survival (OS) of patients with prostate sarcomas.
Methods:
We reported 41 cases diagnosed with prostate sarcomas from eight hospitals in China and retrospectively analyzed the prognostic factors by combining our data with cases from five previously published cohorts, including one extra Chinese cohort and four cohorts from US cohorts. Additionally, we investigated the differences in treatment regimens between China (n = 66) and the USA (n = 74).
Results:
The median survival time of the 41 cases was 18.6 months (95% confidence interval [CI]: 13.9-23.2). The status of negative distant metastasis (P = 0.004) and radical tumor resection with negative margin (P = 0.001) were significantly associated with better overall survival, whereas age, tumor size, duration of initial symptoms, and chemo/radiotherapy were not significantly related to OS. The survival time was longer in patients with rhabdomyosarcoma than in those with leiomyosarcoma (P = 0.049). Combined analysis of the current and 5 prior cohorts showed that more patients in the US cohorts underwent radical surgery (P = 0.005), and the overall survival was better among those with radical cystoprostatectomy compared to those with radical prostatectomy alone (P = 0.008).
Conclusion:
Radical resection to achieve a negative margin contributes to better survival for patients with prostate sarcoma.
