title: Twenty-five cases of adult prostate sarcoma treated at a high-volume institution from 1989 to 2009.
abstract: OBJECTIVE
  To analyze the clinical characteristics, treatment modalities, and outcomes of adult prostate sarcoma treated at our institution.
  
  
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Urology, Sichuan University, Chengdu, Sichuan, People's Republic of China.
authors.forename: Xianding
authors.initials: X
authors.lastname: Wang
authors.forename: Ling
authors.initials: L
authors.lastname: Liu
authors.forename: Haowen
authors.initials: H
authors.lastname: Tang
authors.forename: Zhengsheng
authors.initials: Z
authors.lastname: Rao
authors.forename: Wenli
authors.initials: W
authors.lastname: Zhan
authors.forename: Xiaohong
authors.initials: X
authors.lastname: Li
authors.forename: Hao
authors.initials: H
authors.lastname: Zeng
authors.forename: Peng
authors.initials: P
authors.lastname: Zhang
authors.forename: Bing
authors.initials: B
authors.lastname: Wei
authors.forename: Tao
authors.initials: T
authors.lastname: Lin
authors.forename: Qiang
authors.initials: Q
authors.lastname: Wei
authors.forename: Yiping
authors.initials: Y
authors.lastname: Lu
authors.forename: Xiang
authors.initials: X
authors.lastname: Li
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015653:Cystectomy; D018572:Disease-Free Survival; D006801:Humans; D053208:Kaplan-Meier Estimate; D007890:Leiomyosarcoma / Q000473:pathology* / Q000628:therapy; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D016016:Proportional Hazards Models; D011468:Prostatectomy; D011471:Prostatic Neoplasms / Q000473:pathology* / Q000628:therapy; D012189:Retrospective Studies; D012208:Rhabdomyosarcoma / Q000473:pathology* / Q000628:therapy; D055815:Young Adult