Share This Article:

The Impact of Radical Prostatectomy on the Survival of Patients with Carcinosarcoma of the Prostate

Full-Text HTML Download Download as PDF (Size:179KB) PP. 475-480
DOI: 10.4236/jct.2011.24064    7,879 Downloads   10,696 Views   Citations

ABSTRACT

Background: The objective of this study was to evaluate the impact of radical prostatectomy on carcinosarcoma of the prostate. Methods: Patients diagnosed with carcinosarcoma of the prostate from 1977 through 2007 were identified in the Surveillance, Epidemiology, and End Results (SEER) database. Outcomes were examined with Kaplan-Meier survival analysis and Cox models. The association between clinical and demographic characteristics and survival of carcinosarcoma of the prostate was examined. Results: A total of fifty-four cases of histology confirmed carcinosarcoma of the prostate were identified. Median age of the patients was 74 years (range 28 - 94). Of the patients with a known tumor stage, all but one patient had a locally advanced or distant stage; all of the patients with known histology grade had poorly or undifferentiated histology. Twenty (37%) patients underwent transurethral resection only and Fourteen (25.9%) patients underwent radical prostatectomy. Eight (14%) patients received radiation therapy in combination with surgery. The median cancer specific survival was 16 months (95% CI 0 - 32 months). 1-, 3-, and 5- year cancer specific survival rate were 55.1%, 32.3% and 21.1%. In a multivariate analysis, radical prostatectomy was found to be a significant prognostic factor for cancer-specific survival. Conclusions: Carcinosarcoma of the prostate commonly occurs in older patients and associated with aggressive disease and poor prognosis. Radical prostatectomy is the only treatment modality that significantly improves survival. Emphasis on early diagnosis and detection and multimodality therapy of this disease is needed to improve the outcome for patients with this malignancy.

Conflicts of Interest

The authors declare no conflicts of interest.

Cite this paper

J. Wang and F. Wang, "The Impact of Radical Prostatectomy on the Survival of Patients with Carcinosarcoma of the Prostate," Journal of Cancer Therapy, Vol. 2 No. 4, 2011, pp. 475-480. doi: 10.4236/jct.2011.24064.

References

[1] M. P. Wick and P. E. Swanson, “Carcinosarcomas: Current Perspectives and a Historical Review of Nosological Concepts,” Seminars in Diagnostic Pathology, Vol. 10, No. 2, 1993, pp. 118-127.
[2] S. M. McGee, S. A. Boorjian and R. J. Karnes, “Carcinosarcoma of the Prostate Replacing the Entire Lower Genitourinary Tract,” Urology, Vol. 74, No. 3, 2009, pp. 540-541. doi:10.1016/j.urology.2009.04.057
[3] M. R. Wick, R. H. Young, R. Malvesta, D. S. Beebe, J. J. Hansen and L. P. Dehner, “Prostatic Carcinosarcomas: Clinical, Histologic and Immunohistochemicaldata on Two Cases with a Review of the Literature,” American Journal of Clinical Pathology, Vol. 92, No. 2, 1989, pp. 131-139.
[4] P. A. Dundore, J. C. Cheville, A. G. Nascimento, G. M. Farrow and D. G. Bostwick, “Carcinosarcoma of the Prostate: Report of 22 Cases,” Cancer, Vol. 76, No. 6, 1995, pp. 1035-1042.
[5] A. A. Renshaw and S. R. Granter, “Metastatic Sarcomatoid, and PSA- and PAP-Negative Prostatic Carcinoma: Diagnosis by Fine Needle Aspiration,” Diagnostic Cytopathology, Vol. 23, No. 3, 2000, pp. 199-201.
[6] N. Perez, M. Castillo, Y. Santos, D. Truan, R. Gutierrez, A. Franco, A. Palacin, J. A. Bombi , E. Campo and P. L. Fernandez, “Carcinosarcoma of the Prostate: Two Cases with Distinctive Morphologic and Immunohistochemical Findings,” Virchows Arch, Vol. 446, No. 5, 2005, pp. 511-516. doi:10.1007/s00428-005-1239-x
[7] D. E. Hansel and J. I. Epstein, “Sarcomatoid Carcinoma of the Prostate: A Study of 42 Cases,” American Journal of Surgical Pathology, Vol. 30, No. 10, 2006, pp. 1316-1321.
[8] V. S. Subramanian, M. Coburn and B. J. Miles, “Carcinosarcoma of the Prostate with Multiple Metastases: Case Report and Review of the Literature,” Urologic Oncology, Vol. 23, No. 3, 2005, pp. 181-183. doi:10.1016/j.urolonc.2004.11.010
[9] C. G. Rogers, A. Parwani, A. Tekes, M. P. Schoenberg and J. I. Epstein, “Carcinosarcoma of the Prostate with Urothelial and Squamous Components,” Journal of Urology, Vol. 173, No. 2, 2005, pp. 439-440. doi:10.1097/01.ju.0000149969.76999.7c
[10] T. Fukawa, K. Numata, M. Yamanaka, T. Miyamoto, Y. Kurokawa, H. O. Kanayama, S. Kagawa, M. Utsunomiya and M. Hirokawa, “Prostatic Carcinosarcoma: A Case Report and Review of Literature,” International Journal of Urology, Vol. 10, No. 2, 2003, pp. 108-113. doi:10.1046/j.1442-2042.2003.00574.x
[11] S. E. Canfield, T. H. Gans, P. Unger and S. J. Hall, “Postradiation Prostatic Sarcoma: De Novo Carcinogenesis or Dedifferentiation of Prostatic Adenocarcinoma?” Techniques in Urology, Vol. 7, No. 4, 2001, pp. 294-295.
[12] E. Poblet, A. Gomez-Tierno and L. Alfaro, “Prostatic Carcinosarcoma: A Case Originating in a Previous Ductal Adenocarcinoma of the Prostate,” Pathology Research and Practice, Vol. 196, No. 8, 2000, pp. 569-572.
[13] L. Thompson, B. Chang and S. H. Barsky, “Monoclonal Origins of Malignant Mixed Tumors (Carcinosarcomas). Evidence for a Divergent Histogenesis,” American Journal of Surgical Pathology, Vol. 20, No. 3, 1996, pp. 277-285.
[14] M. E. Ray, K. J. Wojno, N. S. Goldstein, K. B. Olson, R. B. Shah and K. A. Cooney, “Clonality of Sarcomatous and Carcinomatous Elements in Sarcomatoid Carcinoma of the Prostate,” Urology, Vol. 67, No. 2, 2006, pp. 423.e5-423.e8.
[15] L. J. Krastanova and J. C. Addonizio, “Carcinosarcoma of Prostate,” Urology, Vol. 18, No. 1, 1981, pp. 85-88. doi:10.1016/0090-4295(81)90506-9
[16] W. B. Hamlin and P. K. Lund, “Carcinosarcoma of the Prostate: A Case Report,” Journal of Urology, Vol. 97, No. 3, 1967, pp. 518-522.
[17] J. R. Haddad and E. C. Reyes, “Carcinosarcoma of the Prostate with Metastasis of Both Elements: Case Report,” Journal of Urology, Vol. 103, No. 1, 1970, pp. 80-83.
[18] S. C. Quay and K. H. Proppe, “Carcinosarcoma of the Prostate: Case Report and Review of the Literature,” Journal of Urology, Vol. 125, No. 3, 1981, pp. 436-438.
[19] K. Hokamura, T. Kurozumi, K. Tanaka and A. Yamaguchi, “Carcinosarcoma of the Prostate,” Acta Pathologica Japonica, Vol. 35, No. 2, 1985, pp. 481-487.
[20] Surveillance, Epidemiology, and End Results (SEER) Program, Public-Use Data, National Cancer Institute, DCCPS, Surveillance Research Program, Cancer Statistics Branch. http://www.seer.cancer.gov/ about/expansion.html.
[21] SEER Summary Staging Manual, 2000. http://seer.cancer.gov/tools/ssm/
[22] E. L. Kaplan, and P. Meier, “Nonparametric Estimation from Incomplete Observations,” Journal of the American Statistical Association, Vol. 53, 1958, pp. 457-481. doi:10.2307/2281868
[23] D. R. Cox, “Regression Models and Life-Tables,” Journal of the Royal Statistical Society Series B, Vol. 34, 1972, pp. 187-220.
[24] J. L. Young, D. S. Finley and D. K. Ornstein, “Robotic-Assisted Laparoscopic Cystoprostatectomy for Prostatic Carcinosarcoma,” Journal of the Society of Laparoendoscopic Surgeons, Vol. 11, No. 1, 2007, pp. 109-112.
[25] T. Y. Tseng, D. W. Sevilla, J. W. Moul and K. E. Maloney, “Prostatic Carcinosarcoma 15 Years after Combined External Beam Radiation and Brachytherapy for Prostatic Adenocarcinoma: A Case Report,” Prostate Cancer and Prostatic Diseases, Vol. 9, No. 2, pp. 195-197. doi:10.1038/sj.pcan.4500870
[26] P. H. Lange and P. Narayan, “Understaging and Undergrading of Prostate Cancer. Argument for Postoperative Radiation as Adjuvant Therapy,” Urology, Vol. 21, No. 2, 1983, pp. 113-118. doi:10.1016/0090-4295(83)90002-X
[27] B. R. Konety, R. Naraghi, W. Gooding, W. F. O’Donnell and R. R. Bahnson, “Evaluation of Computerized Tomography for Staging of Clinically Localized Adenocarcinoma of the Prostate,” Urologic Oncology, Vol. 2, No. 1, 1996, pp. 14-19.
[28] R. E. Mitchell, M. H. Katz, J. M. McKiernan and M. C. Benson, “The Evaluation and Staging of Clinically Localized Prostate Cancer,” Nature Clinical Practice Urology, Vol. 2, No. 8, 2005, pp. 356-357.

  
comments powered by Disqus

Copyright © 2018 by authors and Scientific Research Publishing Inc.

Creative Commons License

This work and the related PDF file are licensed under a Creative Commons Attribution 4.0 International License.