Adult genitourinary sarcoma: The era of optional chemotherapeutic agents for soft tissue sarcoma

• Published in: International journal of urology 2021-01, Vol.28 (1), p.91-97
• Main Authors: Urasaki, Tetsuya, Nakano, Kenji, Tomomatsu, Junichi, Komai, Yoshinobu, Yuasa, Takeshi, Yamashita, Kyoko, Takazawa, Yutaka, Yamamoto, Shinya, Yonese, Junji, Takahashi, Shunji
• Format: Article
• Language: English
• Subjects: Adult; Aged; Antineoplastic Agents - therapeutic use; Chemotherapy; Drug development; drug therapy; Female; Humans; Male; Malignancy; Medical records; Metastases; Middle Aged; Patients; Prostate; Retrospective Studies; Sarcoma; Sarcoma - drug therapy; Soft Tissue Neoplasms - drug therapy; Soft tissue sarcoma; Survival; Survival Rate; Urinary bladder; urogenital system; Young Adult
• ISSN: 0919-8172; 1442-2042; 1442-2042
• DOI: 10.1111/iju.14417

Objective To report our institutional experience with treatment of primary genitourinary soft tissue sarcoma. Methods We retrospectively reviewed the medical records of adult soft tissue sarcoma patients treated between March 2005 and May 2019. The primary tumor sites included the prostate, kidney, urinary bladder and the paratesticular structures. Results A total of 19 patients – 16 men (84%) and three women (16%) – were enrolled in the study. The median age was 41 years (range 20–79 years). The most common primary site was the prostate (in eight patients; 42%), and prostatic sarcoma patients were younger than patients with sarcomas of other origins. The most common histological subtype was leiomyosarcoma (in five patients; 26%). The overall survival rates after 1, 3 and 5 years were 61.5%, 34.4% and 25.8%, respectively. The median survival time was 20.7 months (95% confidence interval 5.9–35.5 months). Univariate analysis showed that an absence of metastasis at diagnosis and complete surgical resection were predictive of favorable survival. In the chemotherapy group, the objective response rate was 20.5%. Pazopanib was administered to nine patients in the late‐line setting, and the objective response rate was 11.1%; six grade ≥3 adverse events were observed in three patients. Conclusions Inoperable metastatic genitourinary soft tissue sarcoma remains difficult to treat, as previously reported. Further investigation on this malignancy, including optimization of currently available antitumor drugs and the development of novel therapeutic agents, is required.