title: Adult renal sarcoma: clinical features and survival in a series of patients treated at a high-volume institution.
abstract: OBJECTIVE
  To examine the clinical characteristics, treatment, and survival of adult patients with renal sarcoma treated at our institution during the past 2 decades.
  
  
  METHODS
  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.
  
  
  RESULTS
  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).
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Xianding
authors.initials: X
authors.lastname: Wang
authors.forename: Ruiling
authors.initials: R
authors.lastname: Xu
authors.forename: Libo
authors.initials: L
authors.lastname: Yan
authors.forename: Jing
authors.initials: J
authors.lastname: Zhuang
authors.forename: Bing
authors.initials: B
authors.lastname: Wei
authors.forename: Deying
authors.initials: D
authors.lastname: Kang
authors.forename: Ke
authors.initials: K
authors.lastname: Wu
authors.forename: Libo
authors.initials: L
authors.lastname: Xie
authors.forename: Zhiyuan
authors.initials: Z
authors.lastname: Xie
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
authors.forename: Hao
authors.initials: H
authors.lastname: Zeng
authors.forename: Yiping
authors.initials: Y
authors.lastname: Lu
mesh_terms: D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D007680:Kidney Neoplasms / Q000401:mortality* / Q000473:pathology / Q000601:surgery; D007890:Leiomyosarcoma / Q000401:mortality / Q000473:pathology / Q000601:surgery; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000453:epidemiology; D011379:Prognosis; D012189:Retrospective Studies; D012509:Sarcoma / Q000401:mortality* / Q000473:pathology / Q000601:surgery