Prognostic Factors and Outcome of Spermatic Cord Sarcoma
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To evaluate management and outcome in a large series of patients with spermatic cord sarcomas (SCS), a rare malignancy.
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.
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).
Wide excision of the tumor is critical for cure, especially in the liposarcoma subgroup. The role of radiotherapy and chemotherapy is not established.
KeywordsLocal Recurrence Distant Metastasis Liposarcoma Soft Tissue Sarcoma Internal Inguinal Ring
The authors declare no conflict of interest.
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