Abstract
Purpose
To evaluate the outcomes of adult patients with spermatic cord sarcoma (SCS).
Methods
All consecutive patients with SCS managed by the French Sarcoma Group from 1980 to
2017 were analysed retrospectively. Multivariate analysis (MVA) was used to identify
independent correlates of overall survival (OS), metastasis-free survival (MFS), and
local relapse-free survival (LRFS).
Results
A total of 224 patients were recorded. The median age was 65.1 years. Forty-one (20.1%)
SCSs were discovered unexpectedly during inguinal hernia surgery. The most common
subtypes were liposarcoma (LPS) (73%) and leiomyosarcoma (LMS) (12.5%). The initial
treatment was surgery for 218 (97.3%) patients. Forty-two patients (18.8%) received
radiotherapy, 17 patients (7.6%) received chemotherapy. The median follow-up was 5.1
years. The median OS was 13.9 years. In MVA, OS decreased significantly with histology
(HR, well-differentiated LPS versus others = 0.096; p = 0.0224), high grade (HR, 3
versus 1–2 = 2.7; p = 0.0111), previous cancer and metastasis at diagnosis (HR = 6.8;
p = 0.0006). The five-year MFS was 85.9% [95% CI: 79.3–90.6]. In MVA, significant
factors associated with MFS were LMS subtype (HR = 4.517; p < 10-4) and grade 3 (HR = 3.664;
p < 10-3). The five-year LRFS survival rate was 67.9% [95% CI: 59.6–74.9]. In MVA,
significant factors associated with local relapse were margins and wide reresection
(WRR) after incomplete resection. OS was not significantly different between patients
with initial R0/R1 resection and R2 patients who underwent WRR.
Conclusions
Unplanned surgery affected 20.1% of SCSs. A nonreducible painless inguinal lump should
suggest a sarcoma. WRR with R0 resection achieved similar OS to patients with correct
surgery upfront.
Keywords
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Article info
Publication history
Published online: February 25, 2023
Accepted:
February 22,
2023
Received in revised form:
February 10,
2023
Received:
January 20,
2023
Publication stage
In Press Journal Pre-ProofIdentification
Copyright
© 2023 Elsevier Ltd, BASO ~ The Association for Cancer Surgery, and the European Society of Surgical Oncology. All rights reserved.
