Article

Adult renal sarcoma: clinical features and survival in a series of patients treated at a high-volume institution.

Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Urology (Impact Factor: 2.42). 12/2010; 77(4):836-41. DOI: 10.1016/j.urology.2010.09.028
Source: PubMed

ABSTRACT To examine the clinical characteristics, treatment, and survival of adult patients with renal sarcoma treated at our institution during the past 2 decades.
A retrospective review of the demographic, presentation, treatment, and outcome data for 41 adult patients with renal sarcoma treated at our institution from January 1989 to December 2009 was performed. The clinicopathologic parameters were analyzed to determine their effect on survival.
Of the 41 patients, 18 were women and 23 were men. Their median age was 42 years (range 19-76). The median tumor size was 13 cm (range 4-35); 29 cases (70.7%) were high grade. The predominant histologic subtype was leiomyosarcoma (39.0%). At diagnosis, 6 patients (14.6%) had metastatic disease. Surgical resection was performed in 34 patients (82.9%), with negative margins in 22 (53.7%). After a median follow-up of 24 months (range 3-80), 3 patients (8.1%) had survived disease free, 11 (29.7%) were alive with disease, and 23 (62.2%) had died of disease. The overall 1-, 3-, and 5-year survival rate was 86.3%, 40.7%, and 14.5%, respectively, and the median survival was 28 months. The median survival after recurrence was 10 months (range 4-24) and that after metastasis 8 months (range 0-22). On univariate analyses, nonmetastatic disease (P = .001) and surgical resection (P = .000) were predictive of a favorable outcome. On multivariate analyses, surgical resection was the only independent predictor of survival (hazard ratio 35.629, P = .022).
Adult renal sarcoma accounts for 0.8% of renal cancer cases and has a poor prognosis. Early diagnosis and surgical resection offer patients the best chance of survival.

0 Bookmarks
 · 
154 Views
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: To identify factors associated with long-term outcome and to report possibly meaningful clinical features in a unicentric sample of adult urologic sarcomas. MATERIALS AND METHODS: Thirty-five patients treated between 1992 and 2011 were studied. Except for 3 patients, surgery was the initial treatment. The median follow-up in the surviving (censored) patients was 11.3 years. Kaplan-Meier method and competing risk analysis were used to evaluate outcome. Disease recurrence, disease-specific mortality, and overall mortality were the study endpoints. Comparisons were made with the log rank and the Pepe-Mori tests. Cox proportional hazard models were used to identify independent predictors of disease recurrence. RESULTS: Only disease grade was significantly associated with all 3 study endpoints. The primary tumor site was significantly associated with disease-specific and recurrence-free survival but did not reach the significance level concerning overall survival. In the multivariate analysis, primary site and tumor grade were identified as predictors of disease recurrence. Whereas 10-year disease-specific survival was 100% in patients with low grade inguinoscrotal tumors, it was 0% in patients with high grade disease arising from other sites. CONCLUSIONS: Low grade and inguinoscrotal origin are factors associated with favorable outcome in urologic sarcomas. Repeat interventions to remove or to inactivate recurrent tumors or metastases seem to provide clinical benefit in individual cases.
    Urologic Oncology 11/2011; · 3.65 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: OBJECTIVE: To analyze the clinical characteristics, treatment modalities, and outcomes of adult prostate sarcoma treated at our institution. MATERIALS AND METHODS: The medical records of 25 adult patients with prostate sarcoma were obtained from January 1989 to December 2009. The clinicopathologic parameters were evaluated to determine their effect on survival. RESULTS: The median age was 37 years (range 18-81). The median tumor size was 9.5 cm (range 4-25). The median serum prostate-specific antigen level was 1.39 ng/mL (range 0.39-33.20). The most common symptom was dysuria (72%). Transrectal ultrasound-guided needle biopsy was used to diagnose 22 sarcomas, transurethral resection of the prostate to diagnose 2, and open surgery to diagnose 1. The predominant histologic subtype was leiomyosarcoma (40%); 21 (88%) were high grade and 6 patients had metastatic disease. Surgical resection of curative intent was performed in 14 patients, with negative margins in 10. After a median follow-up of 21 months (range 5-63), 2 patients were disease free, 4 were alive with disease, and 19 had died of their disease. Overall, the 1-, 2-, 3-, and 5-year survival rate was 80.0%, 47.4%, 22.6%, and 11.3%, respectively, and the median survival time was 23 months. The median survival time after recurrence was 20 months (range 9-39) and that after metastasis was 10 months (range 3-23). Age >50 years, metastasis at presentation, and a lack of surgery with curative intent were independently predictive of an unfavorable outcome. CONCLUSION: Adult prostate sarcoma accounted for 0.7% of primary prostate malignancies and carried a poor prognosis. Early diagnosis and surgical resection with curative intent offer patients the best chance of survival.
    Urology 04/2013; · 2.42 Impact Factor
  • [Show abstract] [Hide abstract]
    ABSTRACT: The author derives analytical expressions for the Grammians of a model given in modal coordinates for the dynamics of a flexible space structure (FSS). These expressions are then used as the basis for a new algorithm to compute a dominant reduced-order model for such a system in an efficient manner. The resulting reduced-order model is obtained directly rather than by truncating a balanced model of the entire system, thus giving rise to significant efficiency gains for the typical FSS case where the reduced-order model is of very much lower order than the original system
    IEEE Transactions on Automatic Control 04/1990; · 2.72 Impact Factor