成人前列腺肉瘤7例临床分析

目的 :探讨前列腺肉瘤的诊断、治疗及预后因素。　方法 :回顾性分析我院诊治的 7例成人前列腺肉瘤临床表现、实验室检查、治疗方案、病理类型及预后。　结果 :平滑肌肉瘤 3例 ,横纹肌肉瘤 3例 ,恶性神经鞘瘤 1例。前列腺肉瘤有膀胱颈梗阻为主的复合表现 ,确诊依靠病理诊断 ,病理分型与疾病的进展相关联。 2例行根治性膀胱前列腺切除术者于术后 13个月和 2 1个月死亡 ;2例行全盆腔脏器切除术辅以放疗和 (或 )化疗者 ,随访 15个月仍存活 ;3例仅行放疗和 (或 )化疗 ,平均于初诊后 7个月死亡。　结论 :前列腺肉瘤预后较差 ,早期诊断和完整的外科切除有重要意义 ,密切随访可以早期发现复发。

Clinical Analysis of 7 Cases of Adult Prostate Sarcoma

Objective: To investigate the diagnosis, treatment and prognosis of adult prostatic sarcoma. Methods: The records of 7 patients with prostate sarcoma were reviewed in the light of clinical manifestation, laboratory examination, therapeutic methods and histological subtypes. Several clinicopathological variables were assessed for prognostic significance. Results: Of the 7 cases, 3 were leiomyosarcoma, 3 rhabdomyosarcoma and the other malignant neurilemoma. Most patients presented urinary obstruction, and the diagnosis of prostate sarcoma was established with ultrasound guided biopsy. Histological subtypes were related to the rate of survival. Two patients received radical cystoprostatectomy and died 13 and 21 months respectively after operation. Two cases underwent total pelvic exenteration, followed by chemotherapy and/or radiotherapy and still alive 15 months after operation. The other 3 received only chemotherapy and/or radiotherapy and died 7 months on average after diagnosis. Conclusion: The long-term survival rate for adults with prostate sarcoma is low. Early diagnosis and complete surgical resection offer patients the best chance for survival. Long-term surveillance is necessary for the early detection of recurrence.