Department of Urology, West China Hospital, Sichuan University, Chengdu, Sichuan, People's Republic of China.
Urology. 2011 Apr;77(4):836-41. doi: 10.1016/j.urology.2010.09.028. Epub 2010 Dec 13.
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.
分析本机构过去 20 年中收治的成人肾肉瘤患者的临床特征、治疗方法和生存情况。
回顾性分析本机构 1989 年 1 月至 2009 年 12 月收治的 41 例成人肾肉瘤患者的人口统计学、临床表现、治疗和预后资料。分析临床病理参数，以确定其对生存的影响。
41 例患者中，女性 18 例，男性 23 例。中位年龄 42 岁（1976 岁）。肿瘤最大径 13cm（435cm）；29 例（70.7%）为高级别肿瘤。主要组织学亚型为平滑肌肉瘤（39.0%）。诊断时，6 例（14.6%）患者发生转移。34 例患者接受了手术治疗（82.9%），其中 22 例（53.7%）达到了阴性切缘。中位随访 24 个月（380 个月）后，3 例（8.1%）患者无病生存，11 例（29.7%）患者带瘤生存，23 例（62.2%）患者因瘤死亡。总 1、3、5 年生存率分别为 86.3%、40.7%和 14.5%，中位生存时间为 28 个月。复发后中位生存时间为 10 个月（424 个月），转移后中位生存时间为 8 个月（0~22 个月）。单因素分析显示，无转移疾病（P=0.001）和手术切除（P=0.000）是有利预后的预测因素。多因素分析显示，手术切除是唯一的生存独立预测因素（风险比 35.629，P=0.022）。
成人肾肉瘤占肾肿瘤的 0.8%，预后较差。早期诊断和手术切除为患者提供了最佳的生存机会。
