Details

Autor(en) / Beteiligte

• Spiess, Philippe E., M.D
• Kassouf, Wassim, M.D
• Steinberg, Jordan R., M.D
• Tuziak, Tomasz, M.D
• Hernandez, Mike, M.S
• Tibbs, Rita F., M.D
• Czerniak, Bogdan, M.D., Ph.D
• Kamat, Ashish M., M.D
• Dinney, Colin P.N., M.D
• Grossman, H. Barton, M.D

Titel

Review of the M.D. Anderson experience in the treatment of bladder sarcoma

Ist Teil von

• Urologic oncology, 2007, Vol.25 (1), p.38-45

Ort / Verlag

New York, NY: Elsevier Inc

Erscheinungsjahr

2007

Quelle

MEDLINE

Beschreibungen/Notizen

• Abstract Objective To assess the histologic subtypes, clinical presentations, treatment approaches, and treatment-related outcomes of patients with bladder sarcoma. Methods Between January 1985 and July 2004, 19 patients (12 men and 7 women) with primary bladder sarcoma were evaluated at the University of Texas M.D. Anderson Cancer Center. Median follow-up duration was 72 months (range 3–141). Results The median age of patients at presentation was 57 years (range 22–94). The histologic subtypes of bladder sarcoma were leiomyosarcoma (N = 14), angiosarcoma (N = 3), and unclassified sarcoma (N = 2). The clinical presentation consisted of gross, painless hematuria in 79% of patients, lower urinary tract symptoms in 16%, and microhematuria in 5%. The primary treatment modalities used were surgery in 16 (84%) patients, chemotherapy in 2 (11%), and palliation in 1 (5%). The rate of local and distal recurrence was 16% and 53%, respectively. The most common sites of distant metastases were the lungs, bone, brain, and liver. The 5-year disease-specific survival rate was 59%, with a median survival duration of 6 years. There was no statistically significant difference in disease-specific survival between patients with bladder leiomyosarcoma compared to other sarcoma subtypes ( P = 0.149). Lymphovascular invasion ( P = 0.03) and lymphatic metastasis ( P = 0.03) were associated with disease-specific survival, and surgical margin status was associated with recurrence-free ( P = 0.04), disease-specific ( P = 0.03), and overall survival ( P = 0.005). Conclusions Bladder sarcoma is a highly aggressive malignancy, regardless of its histologic subtype. Surgical margin status is an important determinant of survival.