Urologic sarcoma in adults. Memorial Sloan-Kettering Cancer Center experience based on a prospective database between 1982 and 1989.

Urologic sarcoma is a group of rare tumors with a generally poor prognosis. These sarcomas share prognostic characteristics with soft-tissue sarcomas arising from other sites. A staging system that incorporates tumor grade and size is valuable in identifying patients at high risk of dying of disease. Patients with sarcomas that are high-grade, greater than 5 cm in diameter, or metastatic at the time of presentation (MSKCC stages 3 and 4) have a combined 3-year relapse-free survival rate of 26%. Complete surgical resection, preferably with negative margins, still offers the best chance of cure. For reasons that are not clear, multimodality therapy in rhabdomyosarcoma is less effective in adult than in pediatric disease. Present-day chemotherapeutic regimens are ineffective in controlling disseminated sarcoma. The adoption of a uniform staging system coupled with multi-institutional collaboration may allow progress to be made in this otherwise deadly form of genitourinary cancer.