alexa Adult spermatic cord sarcomas: management and results.


Surgery: Current Research

Author(s): Coleman J, Brennan MF, Alektiar K, Russo P

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Abstract BACKGROUND: We present a 20-year surgical experience with spermatic cord sarcoma, describe prognostic features, and evaluate the results of surgical and adjunctive treatments. METHODS: Forty-seven patients were identified from an institutional database. Disease-free survival was calculated, and prognostic factors such as tumor grade, size, extent of operation, and adjuvant therapy were analyzed. RESULTS: The median patient age was 58 years (range, 16-83 years), and the median follow-up was 51 months (range,.5-226 months). The most common tumor types included liposarcoma (51\%), leiomyosarcoma (19\%), embryonal rhabdomyosarcoma (13\%), and malignant fibrous histiocytoma (11\%). Twenty-nine (62\%) patients had high-grade tumors, 21 (45\%) were treated with adjuvant radiation, and 9 (19\%) received chemotherapy. The overall 5- and 10-year disease-specific survival was 75\% and 55\%, respectively. No specific prognostic factors were identified for recurrence or disease-free survival. In 21 patients who underwent reoperative wide resection after a prior incomplete resection, a trend toward improved disease-free survival was noted (P <.059). Of these, six (29\%) had residual viable sarcoma. We could not demonstrate a therapeutic effect of adjuvant radiation or chemotherapy. CONCLUSIONS: We demonstrated that aggressive surgical strategies, including reoperative wide resection, significantly decrease local recurrence and may improve disease free-survival in select patients with spermatic cord sarcoma.
This article was published in Ann Surg Oncol and referenced in Surgery: Current Research

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