Department of Urology, Seoul National University Hospital, Seoul, Korea.
Yonsei Med J. 2011 Sep;52(5):761-7. doi: 10.3349/ymj.2011.52.5.761.
To evaluate the clinicopathological characteristics and prognosis of localized resectable genitourinary sarcomas in adults.
Between September, 1996 and November, 2008, 18 consecutive cases of adults (12 men and 6 women; median age 48.8 years) who were treated for primary genitourinary sarcomas were identified. The following variables were analyzed: patient age, gender, body mass index, American Society of Anesthesiologists (ASA) score, primary organ, tumor histology, size, necrosis, Fédération Nationale des Centres de Lutte Contre le Cancer (FNCLCC) grade, and surgical margin positivity. Recurrence- free survival and disease-specific survival were the study end-points.
The most common presenting symptom was a palpable mass (six cases, 33.3%), the most common site was the kidney (six cases, 33.3%), and the most common histological subtype was leiomyosarcoma (eight patients, 44.4%). Complete resection with negative surgical margins was achieved in 13 patients (72.2%). The median follow-up period was 49.9 months (range 6.4 to 147.6). The recurrence- free survival rates at 1, 3, and 5 years were 81.6%, 66.5%, and 66.5%, respectively. Recurrence-free survival only associated significantly with ASA score (p=0.018). The disease-specific survival rate at 1, 3, and 5 years was 88.9%, 76.2%, and 67.7%, respectively. Disease-specific survival was associated significantly only with FNCLCC grade (p=0.042).
Although genitourinary sarcomas in adults are a rare group of tumors with a poor prognosis, some patients may have a favorable prognosis. Our findings suggest that FNCLCC grade is the most important prognostic factor for these patients.
评估成人局限性可切除泌尿生殖系统肉瘤的临床病理特征和预后。
1996 年 9 月至 2008 年 11 月,连续 18 例成人(12 男 6 女;中位年龄 48.8 岁)因原发性泌尿生殖系统肉瘤接受治疗。分析了以下变量:患者年龄、性别、体重指数、美国麻醉师协会(ASA)评分、原发器官、肿瘤组织学、大小、坏死、法国国立癌症研究中心(FNCLCC)分级和手术切缘阳性。无复发生存和疾病特异性生存是研究终点。
最常见的首发症状是可触及的肿块(6 例,33.3%),最常见的部位是肾脏(6 例,33.3%),最常见的组织学亚型是平滑肌肉瘤(8 例,44.4%)。13 例(72.2%)患者实现了完全切除且切缘阴性。中位随访时间为 49.9 个月(范围 6.4 至 147.6)。1、3、5 年无复发生存率分别为 81.6%、66.5%和 66.5%。无复发生存仅与 ASA 评分显著相关(p=0.018)。1、3、5 年疾病特异性生存率分别为 88.9%、76.2%和 67.7%。疾病特异性生存仅与 FNCLCC 分级显著相关(p=0.042)。
尽管成人泌尿生殖系统肉瘤是一组预后较差的罕见肿瘤,但部分患者可能预后良好。我们的研究结果表明,FNCLCC 分级是这些患者最重要的预后因素。