Prostate Sarcoma:a Retrospective Analysis Of 26 Cases

Background:Sarcomas are a heterogeneous group of tumors arising from mesenchymal tissue.Prostate sarcoma is a rare tumor that arises from prostatic stroma.lt was first illustrated by stafford in 1829 and was first reported by Cao Chen-tao in China.Prostate sarcoma is more common in the young adults.No specific symptom can be found at early stage.Thus,it is easy to be misdiagnosed as other diseases.The symptom of dysuria is similar to patients with BPH.So,We should pay attention to the young patients with dysuria and prostatic enlargement.With the rapid development of urology,medical imaging,pathology and chemoradiotherapy,and the application of Da Vinci Robotic surgery in prostate,the diagnosis and treatment of prostate sarcoma have been improved to some extent.Given all this,we collected and analyzed the clinic data of 26 cases with prostate sarcoma in our hospital and reviewed literature about advances of prostate sarcoma in recent years in order to summarize the current advances in the diagnosis and treatment of the disease.Materials and methods:The records of 26 cases with prostate sarcoma in The First Affiliated Hospital of Zhejiang University,School of Medicine from June 1998 to March 2018 were retrospectively analyzed.The data includes clinical manifestation,imaging,surgical methods and pathology.Based on relevant literature about diagnosis and treatment of prostate sarcoma in recent years,this paper explores the development of diagnosis and treatment of the disease.Results:The pathologic types includes 11 cases of leiomyosarcoma,6 cases of rhabdomyosarcoma,4 cases spindle cell sarcoma,4 cases of fibrosarcoma and 1 case of undifferentiated sarcoma.15 cases underwent radical prostatectomy,3 cases underwent robot-assisted laparoscopic radical prostatectomy,1 case underwent bilateral cutaneous ureterostomy,1 case underwent pelvic mass biopsy and colostomy,4 cases lost the chance of surgical therapy for systemic metastasis,2 cases gave up surgery.Twenty-four of the patients were followed up for 3 to 18(mean 13)months.2 cases were out of follow-up.Twenty-one cases died within 12 months after diagnosis,and 3 cases died 13-18 months after diagnosis.The cause of death in cases was systemic metastasis.Conclusions:Prostate sarcoma is quite rare,but highly aggressive,and always with very poor prognosis.Surgery remains the standard of care.With the application of Da Vinci Robotic surgery in prostate sarcoma,the rapid development of medical imaging,Pathology and chemoradiotherapy,the diagnosis and treatment of prostate sarcoma have improved to some extent.Multiple disciplinary diagnosis and treatment could probably achieve a better prognosis for prostate sarcoma.