Adult Prostate Sarcoma: Demographics, Treatment Patterns, and Survival.

IF 3.4 2区 医学 Q2 ONCOLOGY Annals of Surgical Oncology Pub Date : 2024-12-01 Epub Date: 2024-09-23 DOI:10.1245/s10434-024-16258-w
Carolin Siech, Mario de Angelis, Francesco Di Bello, Natali Rodriguez Peñaranda, Jordan A Goyal, Zhe Tian, Fred Saad, Shahrokh F Shariat, Stefano Puliatti, Nicola Longo, Alberto Briganti, Séverine Banek, Philipp Mandel, Luis A Kluth, Felix K H Chun, Pierre I Karakiewicz
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Abstract

Background: This study aimed to examine clinicopathologic characteristics, treatment patterns, and survival rates in a contemporary population-based cohort of adult prostate sarcoma patients.

Methods: In the Surveillance, Epidemiology, and End Results database (2004-2020), adult patients with prostate sarcoma were identified. Descriptive statistics, Kaplan-Meier analyses, smoothed cumulative incidence plots, and Cox regression models were used.

Results: Of 125 patients, 45 (36%) harbored leiomyosarcoma, 17 (14%) had rhabdomyosarcoma, 15 (12%) had stromal sarcoma, 17 (14%) had sarcoma not otherwise specified (NOS), and 31 (25%) had other sarcoma subtypes. Metastatic stage was most common in the rhabdomyosarcoma patients (44%) and least common in the leiomyosarcoma (21%) and stromal sarcoma (20%) patients. Most of the rhabdomyosarcoma patients received the combination of systemic and radiation therapy with (24%) or without radical surgery (35%), whereas most of the leiomyosarcoma and stromal sarcoma patients underwent radical surgery with (22 and 13%) or without (22 and 47%) radiation. In the overall population, the median overall survival was 27 months. The 5-years overall versus cancer-specific versus other-cause mortality rates were respectively 71 versus 58 versus 13%. In the multivariable Cox regression models, the highest overall mortality was exhibited by the patients with metastatic disease (hazard ratio [HR] 2.87; 95% confidence interval [CI] 1.55-5.31; p < 0.001) or unknown disease stage (HR 2.94; 95% CI 2.20-7.21; p = 0.019). Conversely, of all the histologic subtypes, only stromal sarcoma distinguished itself by lower overall mortality (HR 0.41; 95% CI 0.18-0.96; p = 0.039).

Conclusions: Four major histologic subtypes were identified. Among most adult sarcoma patients, treatment patterns vary according to histology, from multimodal therapy to radical prostatectomy alone. These treatment differences reflect equally important heterogeneity in survival patterns.

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成人前列腺肉瘤:人口统计学、治疗模式和生存率。
背景:本研究旨在研究当代人群中成年前列腺肉瘤患者的临床病理特征、治疗模式和生存率:本研究旨在研究当代基于人群的成年前列腺肉瘤患者队列的临床病理特征、治疗模式和存活率:方法:在监测、流行病学和最终结果数据库(2004-2020 年)中确定了成年前列腺肉瘤患者。使用了描述性统计、卡普兰-梅耶分析、平滑累积发病率图和 Cox 回归模型:在125名患者中,45人(36%)罹患横纹肌肉瘤,17人(14%)罹患横纹肌肉瘤,15人(12%)罹患间质肉瘤,17人(14%)罹患未另作说明的肉瘤(NOS),31人(25%)罹患其他亚型肉瘤。转移期在横纹肌肉瘤患者中最常见(44%),在亮肌肉瘤(21%)和间质肉瘤(20%)患者中最少见。大多数横纹肌肉瘤患者接受了全身治疗和放射治疗相结合的治疗(24%),或未接受根治性手术(35%),而大多数亮肌肉瘤和间质肉瘤患者接受了根治性手术,并接受了放射治疗(22%和 13%)或未接受放射治疗(22%和 47%)。总生存期的中位数为 27 个月。5年总死亡率、癌症特异性死亡率和其他原因死亡率分别为71%、58%和13%。在多变量考克斯回归模型中,转移性疾病(危险比 [HR] 2.87;95% 置信区间 [CI] 1.55-5.31;p < 0.001)或疾病分期不明(HR 2.94;95% CI 2.20-7.21;p = 0.019)患者的总死亡率最高。相反,在所有组织学亚型中,只有间质肉瘤的总体死亡率较低(HR 0.41;95% CI 0.18-0.96;P = 0.039):结论:研究发现了四种主要的组织学亚型。在大多数成人肉瘤患者中,治疗模式因组织学而异,从多模式治疗到单纯前列腺癌根治术。这些治疗差异反映出生存模式的异质性也同样重要。
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来源期刊
CiteScore
5.90
自引率
10.80%
发文量
1698
审稿时长
2.8 months
期刊介绍: The Annals of Surgical Oncology is the official journal of The Society of Surgical Oncology and is published for the Society by Springer. The Annals publishes original and educational manuscripts about oncology for surgeons from all specialities in academic and community settings.
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