Prognostic factors and outcomes of adult spermatic cord sarcoma. A study from the French Sarcoma Group |
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| Affiliation: | 1. Department of Pathology, Centre Georges-François Leclerc, 1 Rue du Professeur Marion, 21000, Dijon, France;2. Department of Surgery, Institut du Cancer de Montpellier, 208 rue des Apothicaires, 34298, Montpellier, France;3. Department of Surgery, Institut Curie, 26 Rue d''Ulm, 75005, Paris, France;4. Department of Surgery, Centre Léon Bérard, 28 Prom. Léa et Napoléon Bullukian, 69008, Lyon, France;5. Department of Surgery, Institut Bergonié, 229 Cours de l''Argonne, 33000, Bordeaux, France;6. Department of Surgery, Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France;7. Department of Surgery, Centre Hospitalier Universitaire hautepierre, 1 Avenue Moliere, 67000, Strasbourg, France;8. Department of Pathology, Institut Bergonié, 229 Cours de l''Argonne, 33000, Bordeaux, France;9. Department of Pathology, Centre Léon Bérard, 28 Prom. Léa et Napoléon Bullukian, 69008, Lyon, France;10. Department of Pathology, Institut Gustave Roussy, 114 Rue Edouard Vaillant, 94800, Villejuif, France;11. Department of Pathology, Institut Universitaire de Cancer de Toulouse Oncopole, avenue Irène Joliot-Curie, 31059, Toulouse, France;12. Department of Biostatistics, Centre Georges-François Leclerc, 1 Rue du Professeur Marion, 21000, Dijon, France;13. Department of Surgery, Centre Georges-François Leclerc, 1 Rue du Professeur Marion, 21000, Dijon, France;14. Department of Medical Oncology, Centre Georges-François Leclerc, 1 Rue du Professeur Marion, 21000, Dijon, France;1. Department of Vascular Surgery, Concord Repatriation General Hospital, Sydney, Australia;2. Department of Colorectal Surgery, Royal Prince Alfred Hospital, Sydney, Australia;3. Surgical Outcomes Research Centre (SOuRCe), Sydney, Australia;4. The Institute of Academic Surgery at RPA, Sydney, Australia;5. University of Sydney, New South Wales, Australia;1. Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini, 4, 20090, Pieve Emanuele, MI, Italy;2. Otorhinolaryngology Unit, IRCCS Humanitas Research Hospital, Via Manzoni 56, Rozzano, MI, Italy;3. Department of Otorhinolaryngology, Yonsei University College of Medicine, Seoul, South Korea;4. Unit of Otorhinolaryngology – Head and Neck Surgery, IRCCS Ospedale Policlinico San Martino, Genoa, Italy;5. Department of Surgical Sciences and Integrated Diagnostics (DISC), University of Genoa, Genoa, Italy;6. Department of Otorhinolaryngology, Gangnam Severance Hospital, Yonsei University College of Medicine, Seoul, South Korea;1. Department of Surgery, Brigham and Women''s Hospital, Harvard Medical School, Boston, MA, USA;2. Department of Surgical Oncology, Fox Chase Cancer Center, Philadelphia, PA, USA;3. Center for Sarcoma and Bone Oncology, Dana-Farber/Brigham and Women''s Cancer Center, Boston, MA, USA;1. The Royal Orthopaedic Hospital, Birmingham, B31 2AP, United Kingdom;2. Birmingham Orthopaedic Network (BON), The Knowledge Hub, B31 2AP, United Kingdom;1. Department of Otorhinolaryngology and Head and Neck Surgery, Radboud University Medical Center, PO Box 9101, Geert Grooteplein Zuid 10, 6525, GA, Nijmegen, the Netherlands;2. Netherlands Comprehensive Cancer Organisation (IKNL), Department of Research and Development, Utrecht, the Netherlands;3. University of Groningen, University Medical Center Groningen, Department of Epidemiology, Groningen, the Netherlands;4. IQ Healthcare, Radboud University Medical Center, PO Box 9101, 6500, HB, Nijmegen, the Netherlands;5. Hospital Network Antwerp, Middelheim Medical Center, Department of Oral and Maxillofacial Surgery, Lindendreef 1, 2020, Antwerp, Belgium |
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| Abstract: | PurposeTo evaluate the outcomes of adult patients with spermatic cord sarcoma (SCS).MethodsAll 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).ResultsA 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.ConclusionsUnplanned 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. |
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| Keywords: | Spermatic cord sarcoma Surgery Treatment Sarcoma unplained excision |
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