Multimodal therapy in the treatment of prostate sarcoma: The Johns Hopkins Experience - Abstract

BACKGROUND: The objective of this study was to evaluate the use of neoadjuvant chemoradiation in patients with prostate sarcoma treated at our institution and report oncological outcomes.

MATERIALS AND METHODS: The records of patients with intermediate- or high-grade prostate sarcoma treated with curative intent at our institution from 1993 to 2013 were reviewed. Patient demographic information, tumor characteristics, and treatment modalities used were assessed. Overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were calculated.

RESULTS: Eight patients met inclusion criteria. The mean age at presentation was 64 years, and urinary obstruction was the most common presenting symptom. All patients underwent surgical resection and neoadjuvant radiation and 6 had concurrent chemotherapy. Four patients received intraoperative radiation. With a median follow-up of 36 months, there were no local recurrences, 6 metastases, 4 deaths from disease, and no deaths from other causes. The median OS and CSS was 67.8 months, with actuarial OS and CSS rates of 100% at 1 year, 75% at 2 years, 62.5% at 3 years, and 62.5% at 5 years. Median RFS was 14.2 months, with actuarial RFS rate of 75% at 1 year, 37.5% at 2 years, and 25% at 3 years.

CONCLUSION: Prostate sarcomas are rarely cured using surgical resection alone. Our cohort treated with a multimodality approach had favorable CSS and RFS compared with historic and contemporary series of surgery alone and no local recurrences. Most patients developed metastatic recurrence, highlighting the aggressive nature of this disease.

Written by:
Ball MW, Sundi D, Reese AC, Meyer CF, Terezakis SA, Efron JE, Schoenberg MP, Epstein JI, Ahuja N, Bivalacqua TJ.   Are you the author?
The James Buchanan Brady Urological Institute and Department of Urology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Urology, Temple University School of Medicine, Philadephia, PA; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Radiation Oncology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Surgery, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Urology, The Albert Einstein College of Medicine and The Montefiore Medical Center, Bronx, NY; Department of Oncology, Johns Hopkins University School of Medicine, Baltimore, MD; Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, MD.  

 

Reference: Clin Genitourin Cancer. 2015 May 2. pii: S1558-7673(15)00095-6.
doi: 10.1016/j.clgc.2015.04.011


PubMed Abstract
PMID: 26003268

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