Adult primary prostate sarcoma: A multi-center cohort study and comparison between Chinese and American cases

Background/objectives: To assess the effects of clinical factors and treatments on the overall survival (OS) of patients with prostate sarcomas. Methods: We reported 41 cases diagnosed with prostate sarcomas from eight hospitals in China and retrospectively analyzed the prognostic factors by combining our data with cases from five previously published cohorts, including one extra Chinese cohort and four cohorts from US cohorts. Additionally, we investigated the differences in treatment regimens between China (n = 66) and the USA (n = 74). Results: The median survival time of the 41 cases was 18.6 months (95% confidence interval [CI]: 13.9-23.2). The status of negative distant metastasis (P = 0.004) and radical tumor resection with negative margin (P = 0.001) were significantly associated with better overall survival, whereas age, tumor size, duration of initial symptoms, and chemo/radiotherapy were not significantly related to OS. The survival time was longer in patients with rhabdomyosarcoma than in those with leiomyosarcoma (P = 0.049). Combined analysis of the current and 5 prior cohorts showed that more patients in the US cohorts underwent radical surgery (P = 0.005), and the overall survival was better among those with radical cystoprostatectomy compared to those with radical prostatectomy alone (P = 0.008). Conclusion: Radical resection to achieve a negative margin contributes to better survival for patients with prostate sarcoma. (C) 2020 Asian Surgical Association and Taiwan Robotic Surgery Association. Publishing services by Elsevier B.V.

Automated summary

The study assessed the prognostic factors for patients with prostate sarcomas and found that negative distant metastasis and radical tumor resection were significantly associated with better overall survival. Age, tumor size, symptom duration, and chemo/radiotherapy were not significantly related to survival. There were differences in treatment regimens between Chinese and US patients, with a higher rate of radical surgery in the US cohort leading to better survival outcomes.