成人原发性前列腺肉瘤的临床病理特点及预后

Clinical characteristics and prognosis of primary prostate sarcoma in adults

目的探讨前列腺肉瘤的临床表现、影像学特点、病理特征、治疗方法和临床预后。方法回顾分析1999年1月至2019年12月收治的12例前列腺肉瘤患者的临床资料,总结分析前列腺肉瘤的临床病理特点,治疗方式及预后。结果12例患者均行超声引导下经直肠前列腺穿刺活检,病理结果为前列腺肉瘤,其中横纹肌肉瘤6例,平滑肌肉瘤3例,未分化肉瘤2例,癌肉瘤1例。2例行根治性膀胱前列腺切除术+回肠代膀胱术,5例行根治性前列腺切除术;3例行放化疗;1例仅行化疗,1例仅行前列腺穿刺活检。12例患者除1例仍在随访外均因肿瘤复发转移死亡,平均生存时间15个月(8~25个月)。结论前列腺肉瘤恶性程度较高,预后差,超声引导下前列腺穿刺活检和MRI有助于明确诊断,确诊主要依靠病理检查,治疗方法以手术为主,辅以放化疗等综合治疗。

Objective To investigate the clinical characteristics,imaging and pathological features,treatment and prognosis of primary prostate sarcoma in adults.Methods A retrospective analysis was performed on the clinical data of 12 patients with primary prostate sarcoma from January 1999 to December 2019 in the First Affiliated Hospital of Sun Yat-Sen University.Results 12 patients were diagnosed as prostate sarcoma by trans-rectal ultrasound prostate(TRUS-biopsy),pathological diagnosis revealed that 6 cases with rhabdomyosarcoma,3 cases with leiomyosarcoma,2 cases with undifferentiated sarcoma and 1 cases with carcinoid sarcoma.2 patients received radical cystoprostatectomy and Bricker operation,5 patients received radical prostatectomy,2 patients received chemotherapy and radiotherapy,1 patients received just chemotherapy,1 patients just underwent prostate biopsy.And postoperative follow-up was performed.They all experienced recurrence and died as a result of disease progression except one patient who is still under follow-up.The average survival time was 15 months.Conclusion Prostate sarcoma is rare and highly malignant.The diagnosis is confirmed by TRUS-biopsy and MRI.Surgery remains the main treatment option,chemotherapy and radiotherapy provide therapeutic benefits.