LAUSR

INTRODUCTION AND OBJECTIVE: Prostate sarcoma is a rare malignancy with a series of different pathological types. The prognosis of prostate sarcoma patients was not fully understood due to its rareness. We reported the survival and characteristics of prostate sarcoma treated at a single high-volume institution. METHODS: The medical records of 39 adult patients from January 2000 to March 2017 with a diagnosis of primary prostate sarcoma were retrieved. Univariate and multivariable Cox regression analysis were applied to identify the predictors of overall survival (OS), progression-free survival (PFS) and metastasis-free survival (MFS). RESULTS: The median OS was 15.2 months (range 2.3171.8), and the OS rate at 1, 3 and 5 years was 69.2%, 23.1% and 10.3%, respectively. Patients were divided into 4 pathology types based on the prognosis (stromal sarcoma, undifferentiated pleomorphic sarcoma and others rare sarcomas; rhabdomyosarcoma; leiomyosarcoma; carcinosarcoma and gastrointestinal stromal tumor (GIST)). The most common histological type was rhabdomyosarcoma (10 cases, 25.6%). Multivariable Cox regression reveled that invasive disease at diagnosis (yes vs no, hazard ratio (HR) 5.69, p [ 0.019), pathological type and adjuvant therapy (yes vs no, HR 0.30, p [ 0.069) was associated with OS. Pathological type was associated with PFS (carcinosarcoma and GIST vs stromal sarcoma, HR 0.09, p [ 0.011), and adjuvant therapy (yes vs no HR 8.66, p [ 0.098) was associated with MFS. CONCLUSIONS: Different pathological types of prostate sarcoma were associated with distinctive prognosis. Patients with carcinosarcoma and GIST of prostate had the longer OS, followed by leiomyosarcoma, rhabdomyosarcoma and stromal sarcoma and others. Pathological type like leiomyosarcoma, carcinosarcoma and GIST, no invasive disease and the application of adjuvant therapy were associated with overall long-term survival. The application of adjuvant therapy may improve the overall survival of these patients. Further studies are needed to identify better treatment strategies for prostate sarcoma especially in the age of precision medicine.