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Paratesticular Liposarcoma: Unusual Patterns of Recurrence and Importance of Margins

  • Bone and Soft Tissue Sarcomas
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Paratesticular liposarcoma (LPS) is a rare entity for which optimal treatment has not been defined. We sought to determine recurrence patterns and prognostic factors.

Methods

A total of 25 patients with localized paratesticular LPS between 1987 and 2009 were reviewed. Actuarial local-recurrence-free survival (LRFS), disease-free-survival (DFS), and overall survival (OS) were determined using the Kaplan–Meier method.

Results

LPS histology was well differentiated for 10 patients (40 %), de-differentiated for 14 (56 %), and pleomorphic for 1 (4 %). Final margins were positive in 8 patients (32 %). Radiation therapy (RT) was given to 10 patients; fields included inguinal canal ± scrotum and low pelvis. LRFS rates at 3 and 5 years were 76 and 67 %. The 3-year LRFS rates were lower in patients with positive margins compared with those with negative margins (29 vs 100 %, p = .0005) and in patients with recurrent versus primary disease (38 vs 83 %, p = .04). Among patients who received surgery and RT, margins remained a significant predictor of local recurrence (p = .009). Interestingly, recurrences in 4 patients tracked along gonadal vessels, and only 1 patient had a distant recurrence. OS at 5 years was 100 %.

Conclusions

For patients with localized paratesticular LPS, positive margins and presentation with recurrent disease are adverse prognostic factors for LRFS. LR for patients with positive margins is still high despite RT; thus aggressive surgery to attain negative margins should be attempted in all cases. The finding of regional recurrences along gonadal vessels should be validated, and imaging studies should be tailored to reflect potential patterns of disease at presentation and subsequent recurrence.

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Author information

Author notes

  1. Melin J. Khandekar MD, PhD

    Present address: Department of Radiation Oncology, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

Authors and Affiliations

  1. Harvard Radiation Oncology Program, Brigham and Women’s Hospital, Boston, MA, USA

    Melin J. Khandekar MD, PhD

  2. Division of Surgical Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Chandrajit P. Raut MD

  3. Center for Sarcoma and Bone Oncology, Dana-Farber Cancer Institute, Boston, MA, USA

    Chandrajit P. Raut MD, Jason L. Hornick MD, PhD & Elizabeth H. Baldini MD, MPH

  4. Department of Pathology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Jason L. Hornick MD, PhD

  5. Senior Biometrician II, Beijing Novartis Pharma Co. Ltd, Beijing, China

    Qian Wang PhD

  6. Department of Radiation Oncology, Brigham and Women’s Hospital and Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA

    Brian M. Alexander MD, MPH & Elizabeth H. Baldini MD, MPH

Authors
  1. Melin J. Khandekar MD, PhD
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  2. Chandrajit P. Raut MD
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  3. Jason L. Hornick MD, PhD
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  6. Elizabeth H. Baldini MD, MPH
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Corresponding author

Correspondence to Elizabeth H. Baldini MD, MPH.

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Khandekar, M.J., Raut, C.P., Hornick, J.L. et al. Paratesticular Liposarcoma: Unusual Patterns of Recurrence and Importance of Margins. Ann Surg Oncol 20, 2148–2155 (2013). https://doi.org/10.1245/s10434-013-2963-0

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  • DOI: https://doi.org/10.1245/s10434-013-2963-0

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