Adult prostatic sarcoma: A contemporary multicenter Rare Cancer Network study

Abstract : IntroductionAdult prostatic sarcoma (PS) is a rare disease. While surgery is considered the standard approach, the role of other therapies is not completely established. We report results of the largest multicentric contemporary cohort of PS patients. Materials and MethodsThis study included 61 adult PS patients treated in 16 American and European Institutions. Median age was 64.4 years (range: 22-87). Curative surgery was delivered in 48 patients (prostatectomy=26, cystoprostatectomy=22), usually with lymphadenectomy (n=40). Curative radiotherapy (RT) was delivered in 32 patients, as radical (n=5), neoadjuvant (n=10), or postoperative treatment (n=17). Eighteen patients received chemotherapy. None of the patients received hormonal therapy. ResultsMedian follow-up was 72 months (95%CI: 55-not reached). Five-year local control (LC), overall survival (OS), cancer-specific survival, disease-free survival, and metastases-free rates were 47%, 53%, 56%, 35%, and 35%, respectively. Notably, curative RT (neoadjuvant, adjuvant, or definitive) was associated with improved 5-year LC (55% vs. 31%, P=0.02) and OS (59% vs. 46%, P=0.1). Surgically treated patients presenting with a cT3-4 tumor (n=31), who received RT (n=24), had a significantly improved 5-year LC (68% vs, 33%, P=0.004) and OS (65% vs. 21%, P<0.001) rates compared to patients not receiving RT. cT4 patients demonstrated a significantly lower 5-year OS (43% vs. 61%, P=0.006) and LC (29% vs. 69%, P<0.001) rates. Histologic subtype was not associated with LC and OS, but patients with prostatic stromal sarcoma, rhabdomyosarcoma, or sarcomatoid carcinoma had worse 5-year LC compared to other types (47% vs. 55%) and OS (49% vs. 58%). ConclusionAdult PS has a poor prognosis. Locally advanced tumors have poor LC and OS rates. Curative RT should be considered part of the multidisciplinary approach to PS.
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https://hal-univ-bourgogne.archives-ouvertes.fr/hal-01577454
Contributeur : Le2i - Université de Bourgogne <>
Soumis le : vendredi 25 août 2017 - 17:24:44
Dernière modification le : jeudi 11 janvier 2018 - 06:28:16

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Berardino De Bari, Bradley Stish, Mark Wayne Ball, Yacob Habboush, Paul Sargos, et al.. Adult prostatic sarcoma: A contemporary multicenter Rare Cancer Network study. The Prostate. Supplement., 2017, 77 (10), pp.1160 - 1166. 〈https://www.ncbi.nlm.nih.gov/pubmed/28594087〉. 〈10.1002/pros.23375〉. 〈hal-01577454〉

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