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  • Title: Prognostic factors and outcome of spermatic cord sarcoma.
    Author: Radaelli S, Desai A, Hodson J, Colombo C, Roberts K, Gourevitch D, Gronchi A.
    Journal: Ann Surg Oncol; 2014 Oct; 21(11):3557-63. PubMed ID: 24802908.
    Abstract:
    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.
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