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Urol Oncol. 2014 Oct;32(7):958-65. doi: 10.1016/j.urolonc.2014.01.025. Epub 2014 Jul 11.

Clinical features of leiomyosarcoma of the urinary bladder: analysis of 183 cases.

Author information

1
Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA.
2
Department of Urology, Massachusetts General Hospital, Harvard Medical School, Boston, MA. Electronic address: afeldman@partners.org.

Abstract

INTRODUCTION:

Experience with management of urinary bladder leiomyosarcoma (LMS) is rare. Therefore, to better elucidate the disease characteristics of urinary bladder LMS, we utilized a large population-based cancer registry to examine the epidemiology, natural history, pathological characteristics, prognostic factors, and treatment outcomes.

MATERIAL AND METHODS:

The Surveillance, Epidemiology, and End Results database (1973-2010) was used to identify cases by tumor site and histology codes. The association between clinical and demographic characteristics and long-term survival was examined.

RESULTS:

A total of 183 histologically confirmed cases were identified between 1973 and 2010. The annual age-adjusted incidence rate was 0.23 cases per 1,000,000 and did not significantly change over time. Median age of the patients was 65 years (interquartile range: 47-78 y). Of the patients with a known pathologic tumor stage (n = 164), 50% had a regional or distant disease. Overall, 63.2% of patients with known histologic grade (n = 106), had poorly differentiated or undifferentiated histology. Most patients (92.9%) received cancer-directed surgery (CDS), with 34.4% having radical or partial cystectomy. Only 7.7% of patients received radiation therapy in combination with surgery. The median disease-specific survival was 46 months. Five- and 10-year cancer-specific survival rates were 47%, and 35%, respectively. On multivariate analysis, a worse outcome was associated with an undifferentiated tumor grade, distant disease, and failure to undergo CDS.

CONCLUSION:

This series represents the largest cohort of LMS of the urinary bladder studied to date. LMS commonly presented as high grade and advanced stage with a poor prognosis. Reduced disease-specific survival was associated with increasing age, undifferentiated tumor grade, distant disease, and failure to undergo CDS.

KEYWORDS:

Cancer; Leiomyosarcoma; Outcomes; Prognostic factors; SEER; Urinary bladder

PMID:
25027684
DOI:
10.1016/j.urolonc.2014.01.025
[Indexed for MEDLINE]

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