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Surgical resection either in the form of radical nephrectomy or in the form of partial nephrectomy represents the mainstay options in the treatment of kidney cancer. In most instances, resecting the tumor bearing kidney or the tumor itself provides durable cancer specific survival rates. However, recurrences may rarely develop in the renal fossa or remnant kidney. Despite its rarity, locally recurrent RCC is a challenging condition in terms of the possible management options and relatively poor prognosis. If technically feasible, wide surgical excision and ensuring negative surgical margins are the most effective treatment options. Repeat surgeries (completion nephrectomy, excision of locally recurrent tumor, or repeat partial nephrectomy) may often be complicated, and perioperative morbidity is a major concern. Open approach has been extensively applied in this context and 5-year cancer specific survival rates have been reported to be around 50%. The roles of minimally invasive surgical options (laparoscopic and robotic approach) and nonsurgical alternatives (cryoablation, radiofrequency ablation) have yet to be described. In selected patients, surgical resection may have to be complemented with (neo)adjuvant radiotherapy or medical treatment.

Yumuşak doku sarkomlarının %5 kadarı genitoüriner sistemde bulunur ve genitoüriner sistem tümörlerinin yaklaşık %1-2'sini oluştururlar. Bu çalışmanın amacı, kliniğimizde takip ve tedavi edilen 15 genitoüriner sistem kaynaklı sarkom hastasının klinik ve patolojik özellikleri ile prognozlarını gözden geçirmektir. Bu retrospektif çalışmaya kliniğimizde 1997-2003 yılları arasında tedavi edilen 15 genitoüriner sarkom hastası dahil edildi. Tüm hastalara açık cerrahi girişim yapıldı ve gerektiğinde cerrahi sonrası kemoterapi ve/veya radyoterapi uygulandı. Hastaların takipleri düzenli aralıklarla yapıldı. Üçü kadın, 12'si erkek olan hastaların, ortalama yaşı 50.4±14.7 (16-69) yıl, ortalama tümör boyutu ise 8±3.5 (3-15) cm idi. Beş hastada mesane , 6 hastada böbrek, 3 hastada retroperitoneal ve 1 hastada prostat kaynaklı sarkom saptandı. Histopatolojik olarak 9'u leyomyosarkom, 2'si rabdomiyosarkom, 3'ü liposarkom ve l'i malin fıbroz histiyositom idi. Hastaların biri hariç tamamına açık cerrahi tedavi uygulandı. Operasyon sonrası 9 hastaya sadece kemoterapi, 2 hastaya kemoradyoterapi yapıldı. Ortalama 10.2+4.7 (3-20) aylık takip süresi sonunda 12 hasta kaybedildi ve ortalama sağkalım % 20 (3/15) olarak saptandı. Genitoüriner ve retroperitoneal sarkomlar nadir görülen ancak prognozu kötü olan tümörlerdir. Bu tümörlerin tedavisinin temelini halen cerrahi tedavi oluşturmaktadır. Introduction: Sarcomas account for only about 1% of all malignant tumors. Less than 5% of soft tissue sarcomas arise from the genitourinary tract, accounting for only 1 to 2% of all malignant genitourinary tumors. Because of the rarity of these tumors, the basic problem in the management of these tumors is the lack of a uniform approach for staging and treatment. Although sarcomas arise from different organs in the genitourinary tract and compromise different histopathological features, the main treatment modality is surgical resection of the tumor. The aim of this study is to evaluate the clinical and pathological features and prognosis of genitourinary tumors treated in our clinic. Materials and Methods: Between 1997 and 2003, after excluding the gynecological sarcomas, a total of 15 genitourinary sarcomas were treated in our clinic. All patients were evaluated with a detailed medical history, physical examination, multiple serum analyses and imaging modalities such as ultrasonography, computed tomography and magnetic resonance imaging if needed. Thus, tru-cut biopsy was performed if indicated. For all patients, the primary treatment modality was open surgical resection. In addition to surgery, some of these patients also received adjuvant radiation therapy and/or chemotherapy. For staging, Memorial Sloan-Kettering Cancer Center soft tissue sarcoma staging system was used. Post-operative follow-up was done in regular intervals. Results: The mean age of patients was 50.4 ±14.7 (16-69) years and the mean tumor size was 8±3.5 cm. The chief complaints (one or more) of these patients were hematuria in 9, flank pain in 7, weight loss in 6, abdominal pain in 5, abdominal mass in 4, lower urinary tract symptoms in 3. Five bladder, six kidney, three retroperitoneal and one prostate sarcoma were detected in three women and 12 men. Histopathology of these tumors were leiomyosarcomas in nine, liposarcomas in three, rhabdomyosarcomas in two, malignant fibrous histiocytoma in one of the patients. Of these tumors, three were low grade and 12 were high grade. All patients except one underwent open surgical resection of the tumors. For five patients surgical resection was the only treatment modality, while eleven patients received adjuvant chemotherapy and/or radiotherapy after surgery. After a follow-up of 10.2± 4.7 (3-20) months, overall survival rate was found to be 20% (3/15). Conclusion: Genitourinary sarcomas are a rare group of tumors with a generally poor prognosis. Complete surgical resection is still the mainstay of treatment. Further large scale studies, are needed to better understand the major prognostic determinants of these tumors and to identify specific treatments.

Yumuşak doku sarkomlarının %5 kadarı genitoüriner sistemde bulunur ve genitoüriner sistem tümörlerinin yaklaşık %1-2'sini oluştururlar. Bu çalışmanın amacı, kliniğimizde takip ve tedavi edilen 15 genitoüriner sistem kaynaklı sarkom hastasının klinik ve patolojik özellikleri ile prognozlarını gözden geçirmektir. Bu retrospektif çalışmaya kliniğimizde 1997-2003 yılları arasında tedavi edilen 15 genitoüriner sarkom hastası dahil edildi. Tüm hastalara açık cerrahi girişim yapıldı ve gerektiğinde cerrahi sonrası kemoterapi ve/veya radyoterapi uygulandı. Hastaların takipleri düzenli aralıklarla yapıldı. Üçü kadın, 12'si erkek olan hastaların, ortalama yaşı 50.4±14.7 (16-69) yıl, ortalama tümör boyutu ise 8±3.5 (3-15) cm idi. Beş hastada mesane , 6 hastada böbrek, 3 hastada retroperitoneal ve 1 hastada prostat kaynaklı sarkom saptandı. Histopatolojik olarak 9'u leyomyosarkom, 2'si rabdomiyosarkom, 3'ü liposarkom ve l'i malin fıbroz histiyositom idi. Hastaların biri hariç tamamına açık cerrahi tedavi uygulandı. Operasyon sonrası 9 hastaya sadece kemoterapi, 2 hastaya kemoradyoterapi yapıldı. Ortalama 10.2+4.7 (3-20) aylık takip süresi sonunda 12 hasta kaybedildi ve ortalama sağkalım % 20 (3/15) olarak saptandı. Genitoüriner ve retroperitoneal sarkomlar nadir görülen ancak prognozu kötü olan tümörlerdir. Bu tümörlerin tedavisinin temelini halen cerrahi tedavi oluşturmaktadır. Introduction: Sarcomas account for only about 1% of all malignant tumors. Less than 5% of soft tissue sarcomas arise from the genitourinary tract, accounting for only 1 to 2% of all malignant genitourinary tumors. Because of the rarity of these tumors, the basic problem in the management of these tumors is the lack of a uniform approach for staging and treatment. Although sarcomas arise from different organs in the genitourinary tract and compromise different histopathological features, the main treatment modality is surgical resection of the tumor. The aim of this study is to evaluate the clinical and pathological features and prognosis of genitourinary tumors treated in our clinic. Materials and Methods: Between 1997 and 2003, after excluding the gynecological sarcomas, a total of 15 genitourinary sarcomas were treated in our clinic. All patients were evaluated with a detailed medical history, physical examination, multiple serum analyses and imaging modalities such as ultrasonography, computed tomography and magnetic resonance imaging if needed. Thus, tru-cut biopsy was performed if indicated. For all patients, the primary treatment modality was open surgical resection. In addition to surgery, some of these patients also received adjuvant radiation therapy and/or chemotherapy. For staging, Memorial Sloan-Kettering Cancer Center soft tissue sarcoma staging system was used. Post-operative follow-up was done in regular intervals. Results: The mean age of patients was 50.4±14.7 (16-69) years and the mean tumor size was 8±3.5 cm. The chief complaints (one or more) of these patients were hematuria in 9, flank pain in 7, weight loss in 6, abdominal pain in 5, abdominal mass in 4, lower urinary tract symptoms in 3. Five bladder, six kidney, three retroperitoneal and one prostate sarcoma were detected in three women and 12 men. Histopathology of these tumors were leiomyosarcomas in nine, liposarcomas in three, rhabdomyosarcomas in two, malignant fibrous histiocytoma in one of the patients. Of these tumors, three were low grade and 12 were high grade. All patients except one underwent open surgical resection of the tumors. For five patients surgical resection was the only treatment modality, while eleven patients received adjuvant chemotherapy and/or radiotherapy after surgery. After a follow-up of 10.2±4.7 (3-20) months, overall survival rate was found to be 20% (3/15). Conclusion: Genitourinary sarcomas are a rare group of tumors with a generally poor prognosis. Complete surgical resection is still the mainstay of treatment. Further large scale studies, are needed to better understand the major prognostic determinants of these tumors and to identify specific treatments.