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Annals of Surgical Oncology 10:669-675 (2003)
© 2003 Society of Surgical Oncology

ORIGINAL ARTICLES

Adult Spermatic Cord Sarcomas: Management and Results

Jonathan Coleman, MD, Murray F. Brennan, MD, Kaled Alektiar, MD and Paul Russo, MD

From the Departments of Urology (JC, PR), Surgery (MFB), and Radiation Oncology (KA), Memorial Sloan-Kettering Cancer Center, New York, New York.

Correspondence: Address correspondence and reprint requests to: Paul Russo, MD, The Sidney Kimmel Center for Prostate and Urologic Cancers, 353 East 68th Street, Room 525, New York, NY 10021; Fax: 212-988-0760; E-mail: russop{at}mskcc.org

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.

Key Words: Sarcoma • Spermatic cord • Paratesticular • Re-resection




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