Adult urologic sarcomas: a single institution experience over 25 years

Area of Science:

• Oncology
• Urology
• Soft Tissue Sarcoma Research

Background:

• Genitourinary (GU) sarcomas are rare soft tissue malignancies, accounting for ~2% of GU cancers.
• Limited data exist on optimal management and long-term outcomes due to their rarity.
• This study analyzes a 25-year single-institution experience to identify trends and prognostic factors.

Purpose of the Study:

• To evaluate clinical presentation, treatment strategies, and survival outcomes of GU sarcomas.
• To identify trends in management and prognosis over a 25-year period.
• To determine potential predictors of survival for patients with GU sarcomas.

Main Methods:

• Retrospective review of patients (≥18 years) diagnosed with GU sarcomas (1998-2023).
• Analysis of tumor subtype, staging, histopathology, treatment, and survival outcomes.
• Kaplan-Meier analysis for recurrence-free survival (RFS) and overall survival (OS).

Main Results:

• 33 cases identified: liposarcoma (LPS, n=15), leiomyosarcoma (LMS, n=12), rhabdomyosarcoma (RMS, n=5).
• Paratesticular tumors were most frequent (n=23).
• LMS showed higher stage, grade, recurrence (25%), and mortality (41.7%) vs. LPS (recurrence 13.3%, mortality 20%). At 36 months, RFS was 63% and OS was 81% for the cohort.

Conclusions:

• Surgical resection is the primary treatment for GU sarcomas.
• Margin status, tumor grade, and size are critical prognostic factors.
• LMS has the highest recurrence risk; RMS shows aggressive progression. Targeted therapies require further investigation.