PURPOSE: To evaluate management and outcome in a large series of patients with spermatic cord sarcomas (SCS), a rare malignancy. METHODS: Eighty-two patients with localized SCS treated at two dedicated sarcoma units between 1992 and 2013 were included. Disease-specific survival (DSS) and crude cumulative incidence of local recurrence and distant metastases (DM) were estimated by Kaplan-Meier plots and log rank tests. RESULTS: Median follow-up was 33 months (interquartile range 13-72 months). Sixty-one patients presented with primary disease. Liposarcoma was the most common histotype, but surprisingly, 37 % of tumors were of high grade. Seventeen patients (21 %) received radiotherapy and 12 patients (15 %) chemotherapy. Five-year DSS for the whole series was 92 % [95 % confidence interval (CI) 83-97]. Five-year rates of local recurrence and DM were 26 % (95 % CI 15-42) and 24 % (95 % CI 15-38), respectively. Tumor grade was found to be a significant predictor of both DSS and DM (both p < 0.001). Quality of surgical margins was proved to affect the local outcome (p = 0.025), while the rates of distant metastases were found to differ significantly by histology (p = 0.010). Exclusively in the liposarcoma subgroup, quality of surgical margins was also directly associated with DSS (p = 0.043). CONCLUSIONS: Wide excision of the tumor is critical for cure, especially in the liposarcoma subgroup. The role of radiotherapy and chemotherapy is not established.
PURPOSE: To evaluate management and outcome in a large series of patients with spermatic cord sarcomas (SCS), a rare malignancy. METHODS: Eighty-two patients with localized SCS treated at two dedicated sarcoma units between 1992 and 2013 were included. Disease-specific survival (DSS) and crude cumulative incidence of local recurrence and distant metastases (DM) were estimated by Kaplan-Meier plots and log rank tests. RESULTS: Median follow-up was 33 months (interquartile range 13-72 months). Sixty-one patients presented with primary disease. Liposarcoma was the most common histotype, but surprisingly, 37 % of tumors were of high grade. Seventeen patients (21 %) received radiotherapy and 12 patients (15 %) chemotherapy. Five-year DSS for the whole series was 92 % [95 % confidence interval (CI) 83-97]. Five-year rates of local recurrence and DM were 26 % (95 % CI 15-42) and 24 % (95 % CI 15-38), respectively. Tumor grade was found to be a significant predictor of both DSS and DM (both p < 0.001). Quality of surgical margins was proved to affect the local outcome (p = 0.025), while the rates of distant metastases were found to differ significantly by histology (p = 0.010). Exclusively in the liposarcoma subgroup, quality of surgical margins was also directly associated with DSS (p = 0.043). CONCLUSIONS: Wide excision of the tumor is critical for cure, especially in the liposarcoma subgroup. The role of radiotherapy and chemotherapy is not established.
Authors: Raquel Sopeña-Sutil; Francesco Silan; Maria Teresa Butron-Vila; Felix Guerrero-Ramos; Emilio Lagaron-Comba; Juan Passas-Martinez Journal: Can Urol Assoc J Date: 2016-09-13 Impact factor: 1.862
Authors: Massimo Iafrate; Giovanni Motterle; Carlotta Zaborra; Niccolò Leone; Tommaso Prayer-Galetti; Filiberto Zattoni; Andrea Guttilla; Rocco Cappellesso; Angelo Paolo Dei Tos; Carlo Riccardo Rossi; Paolo Del Fiore; Marco Rastrelli; Simone Mocellin Journal: Front Surg Date: 2020-11-17