Abstract
Introduction
Renal sarcomas are exceedingly rare and lack a prognostic stage classification. We
thus aimed to investigate the contemporary clinicopathologic characteristics and outcomes
of renal sarcomas at a national level.
Patients and Methods
We utilized the Surveillance, Epidemiology, and End Results database to extract data
on patients with renal sarcoma diagnosed between 2004 and 2015. We estimated median,
1-, 3-, and 5-year overall survival (OS) probabilities via Kaplan-Meier curves and
used multivariable regression to compare OS between different patient groups.
Results
We identified 365 patients; at diagnosis, 104 patients (28.5%) had stage I disease
(T1N0M0), 133 patients (36.4%) patients had stage II disease (T2-4N0M0), and 117 patients
(32.1%) patients had stage III disease (any T, N1, or M1). Median survival was 105
months (interquartile range [IQR], 29 – not reached) for stage I disease, 46 months
(IQR 14-118 months) for stage II disease, 8 months (IQR 3-28 months) for stage III
disease, and 32 months (IQR, 8-116 months) for the entire cohort. Patient age (hazard
ratio [HR] for death [per year] 1.02, 95% confidence interval [95% CI] 1.00-1.04),
stage (II vs. I: HR 1.71, 95% CI 1.00-2.92; III vs. I: HR 4.93, 95% CI 2.68-9.05), grade (grade 3 vs. grade 1: 3.07, 95% CI 1.18-8.00; grade 4 vs. grade 1: HR 3.66, 95% CI 1.41-9.49), and possessing medical insurance (HR 0.40, 95%
CI 0.16-0.94) were independently and significantly associated with OS. Performance
of nephrectomy also trended towards independently improving OS (HR 0.23, 95% CI 0.05-1.09).
Conclusion
A novel staging classification for renal sarcomas into a 3-stage system based on Tumor
Node Metastasis (TNM) criteria produces distinct survival curves, although further
studies are needed to robustly assess its validity.
Keywords
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Article info
Publication history
Published online: July 29, 2022
Accepted:
July 26,
2022
Received in revised form:
July 22,
2022
Received:
November 11,
2021
Identification
Copyright
© 2022 Elsevier Inc. All rights reserved.
