Multimodal Therapy in the Treatment of Prostate Sarcoma

The Johns Hopkins Experience

Mark W. Ball, Debasish Sundi, Adam C. Reese, Christian F. Meyer, Stephanie A. Terezakis, Jonathan E. Efron, Mark P. Schoenberg, Jonathan I. Epstein, Nita Ahuja, Trinity J. Bivalacqua

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

Background: The objective of this study was to evaluate the use of neoadjuvant chemoradiation in patients with prostate sarcoma treated at our institution and report oncological outcomes. Materials and Methods: The records of patients with intermediate- or high-grade prostate sarcoma treated with curative intent at our institution from 1993 to 2013 were reviewed. Patient demographic information, tumor characteristics, and treatment modalities used were assessed. Overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were calculated. Results: Eight patients met inclusion criteria. The mean age at presentation was 64 years, and urinary obstruction was the most common presenting symptom. All patients underwent surgical resection and neoadjuvant radiation and 6 had concurrent chemotherapy. Four patients received intraoperative radiation. With a median follow-up of 36 months, there were no local recurrences, 6 metastases, 4 deaths from disease, and no deaths from other causes. The median OS and CSS was 67.8 months, with actuarial OS and CSS rates of 100% at 1 year, 75% at 2 years, 62.5% at 3 years, and 62.5% at 5 years. Median RFS was 14.2 months, with actuarial RFS rate of 75% at 1 year, 37.5% at 2 years, and 25% at 3 years. Conclusion: Prostate sarcomas are rarely cured using surgical resection alone. Our cohort treated with a multimodality approach had favorable CSS and RFS compared with historic and contemporary series of surgery alone and no local recurrences. Most patients developed metastatic recurrence, highlighting the aggressive nature of this disease.

Original languageEnglish (US)
Pages (from-to)435-440
Number of pages6
JournalClinical Genitourinary Cancer
Volume13
Issue number5
DOIs
StatePublished - Oct 1 2015

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Sarcoma
Prostate
Survival
Recurrence
Therapeutics
Neoplasms
Survival Rate
Radiation
Cause of Death
Demography
Neoplasm Metastasis
Drug Therapy

Keywords

  • Leiomyosarcoma
  • Mesenchymal tumor
  • Neoadjuvant chemotherapy
  • Radiation
  • Surgery

ASJC Scopus subject areas

  • Oncology
  • Urology

Cite this

Ball, M. W., Sundi, D., Reese, A. C., Meyer, C. F., Terezakis, S. A., Efron, J. E., ... Bivalacqua, T. J. (2015). Multimodal Therapy in the Treatment of Prostate Sarcoma: The Johns Hopkins Experience. Clinical Genitourinary Cancer, 13(5), 435-440. https://doi.org/10.1016/j.clgc.2015.04.011

Multimodal Therapy in the Treatment of Prostate Sarcoma : The Johns Hopkins Experience. / Ball, Mark W.; Sundi, Debasish; Reese, Adam C.; Meyer, Christian F.; Terezakis, Stephanie A.; Efron, Jonathan E.; Schoenberg, Mark P.; Epstein, Jonathan I.; Ahuja, Nita; Bivalacqua, Trinity J.

In: Clinical Genitourinary Cancer, Vol. 13, No. 5, 01.10.2015, p. 435-440.

Research output: Contribution to journalArticle

Ball, MW, Sundi, D, Reese, AC, Meyer, CF, Terezakis, SA, Efron, JE, Schoenberg, MP, Epstein, JI, Ahuja, N & Bivalacqua, TJ 2015, 'Multimodal Therapy in the Treatment of Prostate Sarcoma: The Johns Hopkins Experience', Clinical Genitourinary Cancer, vol. 13, no. 5, pp. 435-440. https://doi.org/10.1016/j.clgc.2015.04.011
Ball, Mark W. ; Sundi, Debasish ; Reese, Adam C. ; Meyer, Christian F. ; Terezakis, Stephanie A. ; Efron, Jonathan E. ; Schoenberg, Mark P. ; Epstein, Jonathan I. ; Ahuja, Nita ; Bivalacqua, Trinity J. / Multimodal Therapy in the Treatment of Prostate Sarcoma : The Johns Hopkins Experience. In: Clinical Genitourinary Cancer. 2015 ; Vol. 13, No. 5. pp. 435-440.
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abstract = "Background: The objective of this study was to evaluate the use of neoadjuvant chemoradiation in patients with prostate sarcoma treated at our institution and report oncological outcomes. Materials and Methods: The records of patients with intermediate- or high-grade prostate sarcoma treated with curative intent at our institution from 1993 to 2013 were reviewed. Patient demographic information, tumor characteristics, and treatment modalities used were assessed. Overall survival (OS), cancer-specific survival (CSS), and recurrence-free survival (RFS) were calculated. Results: Eight patients met inclusion criteria. The mean age at presentation was 64 years, and urinary obstruction was the most common presenting symptom. All patients underwent surgical resection and neoadjuvant radiation and 6 had concurrent chemotherapy. Four patients received intraoperative radiation. With a median follow-up of 36 months, there were no local recurrences, 6 metastases, 4 deaths from disease, and no deaths from other causes. The median OS and CSS was 67.8 months, with actuarial OS and CSS rates of 100{\%} at 1 year, 75{\%} at 2 years, 62.5{\%} at 3 years, and 62.5{\%} at 5 years. Median RFS was 14.2 months, with actuarial RFS rate of 75{\%} at 1 year, 37.5{\%} at 2 years, and 25{\%} at 3 years. Conclusion: Prostate sarcomas are rarely cured using surgical resection alone. Our cohort treated with a multimodality approach had favorable CSS and RFS compared with historic and contemporary series of surgery alone and no local recurrences. Most patients developed metastatic recurrence, highlighting the aggressive nature of this disease.",
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AU - Efron, Jonathan E.

AU - Schoenberg, Mark P.

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