30 years of institutional experience in treatment of adult sarcoma of the prostate

Although the vast majority of cases of prostate cancer are caused by adenocarcinomas of the prostate, every so often we try to ensure that we provide readers with updated information on the management of the much rare forms of prostate cancer.

In today’s update we address sarcomas, including leiomyosarcomas and rhabdomyosarcomas. Sarcomas of the prostate are very rare but they occur in both adults and children.

In children it appears that rhabdomyoscarcomas are more common that leiomyosarcomas. Also, in children, long-term survival is possible in about 50 to 60 percent of patients with rhabdomyosarcomas, but there is significant risk for tumor recurrences and for urinary tract complications associated with treatment. For children diagnosed with leiomyosarcoma, long-term survival is possible in about 50 percent of cases. (See this on-line review article on prostate sarcoma.)

In a recent clinical review article, Musser et al., from the Memorial Sloan-Kettering Cancer Center, have provided data on their experience from treating just 38 cases of sarcoma of the prostate in adults over the 30 years from 1982 to 2012.

Here is what they report:

  • The 38 patients had an average (median) age of 50 years (ranging from 17 to 73).
  • Diagnosis was most commonly established by prostate biopsy (26/38 cases, 68 percent) or by transurethral resection of the prostate (7/38 cases, 18 percent).
  • Urological symptoms of a clinical problem were evident in most patients, including
    • Blood in the urine (hematuria) in 9/38 patients (24 percent)
    • Acute urinary retention in 8/38 patients (21 percent)
    • Other lower urinary tract symptoms in  17/38 patients (45 percent)
  • The two most common types of sarcoma identified were
    • Leiomyosarcoma in 13/38 cases (34 percent)
    • Rhabdomyosarcoma in 12/38 cases (32 percent)
  • Median cancer-specific survival times post-diagnosis were relatively short.
    • 2.9 years for all men with a sarcoma of any type
    • 1.5 years for men diagnosed with metastatic disease
    • 7.7 years for men diagnosed with localized disease
  • Men diagnosed with rhabdomyosarcoma had a much poorer cancer-specific survival rate than those diagnosed with leiomyosarcoma (hazard ratio = 3.0).

The authors note that surgery (often a cystoprostatectomy) is the standard of care for men with any form of sarcoma of the prostate (if surgery is even possible), but surgery can provide only limited benefit to those with metastatic disease or as a consolidation therapy after partial response to systemic therapy (usually chemotherapy).

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s

This site uses Akismet to reduce spam. Learn how your comment data is processed.

%d bloggers like this: