Outcomes Of Adult Urogenital Sarcomas: Analysis Of Surveillance, Epidemiology, And End Results (Seer) Database 2004 To 2015

423 Background: Urogenital sarcomas are rare type of soft tissue sarcomas and represent only 1-2% of all genitourinary cancers. Given the paucity of literature, we aimed to study the clinical characteristics and factors impact outcomes of adult urological sarcomas. Methods: Adult males aged ≥ 20 years with sarcomas primarily originating from urogenital sites were identified from national SEER database between 2004-2015. Descriptive analysis was performed for all cases. Survival analysis, including Kaplan Meier estimates and Cox regression were performed. Results: A total of 1177 genitourinary sarcomas were identified. Urinary bladder (20.56%) was the most common primary site followed by spermatic cord (20.31%) and kidney (17.33%). The most common histological subtype was liposarcoma (32.9%) followed by leiomyosarcoma (32.0%). 10-year survival rate was highest for liposarcoma 58.3% (95% CI 50.3-65.5) followed by leiomyosarcoma 40.2% (95% CI 32.0-48.2), rhabdomyosarcoma 37.3% (95% CI 22.6-52.1), synovial sarcoma 22.7% (95% CI 5.6-46.6), carcinosarcoma 8.9% (95% CI 4.3-15.4) and 0% for angiosarcoma. Median follow up was 23 months and overall median survival was 54 months. There was a significant overall survival difference by age, race, primary sites, histological subtypes, grade, stage, insurance status, geographic, socioeconomic status and treatment in both univariate and multivariate analysis. On multivariate analysis, factors associated with unfavorable prognosis include age > 75 years (HR 3.9, 95% CI 2.9-5.2), distant metastasis (HR 2.0, 95% CI 1.5-2.7), ureteral sarcomas (HR 6.2, 95% CI 2.3-17.1) and having Medicaid insurance (HR 1.7, 95% CI 1.2-2.3).Surgery alone (HR 0.5, 95% CI 0.4-0.7) or in combination with chemotherapy (HR 0.4, 95% CI 0.3-0.6) or radiation (HR 0.4, 95% CI 0.3-0.6) had favorable prognosis compared to non-surgical approach. Conclusions: Urinary bladder is the most common primary sites of all urological sarcomas. Our study showed age > 75, poorly differentiated histology, angiosarcoma subtype, ureteral primary site, distant metastasis, poor socioeconomic status, Appalachian area and radiation alone were associated with less favorable outcomes.