Abstract
Background and purpose
Rectal sarcomas (RS) are rare malignant tumors with a very poor prognosis. This study
aimed to assess the characteristics, treatment, and outcomes of RS in the United States.
Methods
This study was a retrospective analysis of the National Cancer Database (NCDB) from
2004 to 2019 of patients with a diagnosis of RS. The main outcome measures were overall
survival (OS) and its predictors.
Results
133 RS patients (39.1% female) with a mean age of 65.7 ± 15.6 years were included
in the study. Mean tumor size was 6.1 ± 3 cm. The crude OS rate was 22.5% and median
survival duration was 10.1 (IQR: 3.2–21) months. Factors associated with an improved
OS on were private insurance (HR = 0.23, p = 0.001) and undergoing surgery (HR 0.23,
p < 0.001), Factors associated with poor survival were age (HR 1.02, p = 0.005), male
sex (HR 2.27, p = 0.001), Charlson score of 3 (HR 5.17, p = 0.003), and positive resection
margins (HR: 2.64, p = 0.01). Multivariate Cox regression analysis revealed that male
sex (HR 2.16, p = 0.04) and positive resection margins (HR 2.31, p = 0.03) were predictors
of poor survival whereas surgery was an independent predictor of improved OS (HR 0.321,
p < 0.001)
Conclusions
RS is a very rare rectal malignancy with an even poorer prognosis than previously
reported. However, undergoing surgery with curative intent while obtaining negative
margins may confer better OS.
Keywords
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Article info
Publication history
Published online: October 19, 2022
Accepted:
October 17,
2022
Received in revised form:
September 5,
2022
Received:
June 14,
2022
Identification
Copyright
© 2022 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
