Spermatic cord sarcoma

Outcome, patterns of failure and management

Matthew Ballo, Gunar K. Zagars, Peter W.T. Pisters, Barry W. Feig, Shreyaskumar R. Patel, Andrew C. Von Eschenbach

Research output: Contribution to journalArticle

93 Citations (Scopus)

Abstract

Purpose: We evaluate the outcome, clarify the patterns of failure and suggest treatment strategies for sarcoma in the spermatic cord. Materials and Methods: Between 1956 and 1998, 32 patients with spermatic cord sarcoma were treated at M. D. Anderson Cancer Center. A retrospective review of disease outcome, patterns of relapse and patient survival was performed. Results: Histological subtypes of sarcoma were malignant fibrous histiocytoma in 12 patients, leiomyosarcoma in 6, liposarcoma in 8 and other subtypes in 6. All except 2 patients underwent radical orchiectomy with or without additional resection to achieve negative margins. Margins were microscopically negative in 29 cases and positive in 3. There were 3 patients who received adjuvant radiation to the surgical site. With a median followup of 9 years the 10 and 15-year actuarial local control, distant metastasis-free and overall survival rates were 72% and 61%, 85% and 85%, and 63% and 52%, respectively. The major pattern of failure was local recurrence that occurred in 8 of the 12 patients in whom disease relapsed and was the sole site of relapse in 7. Pelvic nodes had relapsed in 2 patients and para-aortic nodes in 1. Hematogenous metastases had developed in 4 patients. Of the 7 cases of disease that recurred locally only 3 were salvaged. No relapse occurred in the 3 patients treated with combined surgery and radiation. Conclusions: Spermatic cord sarcoma has a high propensity for local recurrence after surgery. Nodal relapse is less frequent than commonly believed. Because of the relatively high local failure rate seen in surgery alone and durable local control noted in 3 patients treated with surgery plus radiotherapy, combined modality treatment should be considered in those with spermatic cord sarcoma who are believed to be ar high risk for local failure.

Original languageEnglish (US)
Pages (from-to)1306-1310
Number of pages5
JournalJournal of Urology
Volume166
Issue number4
DOIs
StatePublished - Jan 1 2001
Externally publishedYes

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Spermatic Cord
Sarcoma
Recurrence
Radiation
Neoplasm Metastasis
Malignant Fibrous Histiocytoma
Liposarcoma
Orchiectomy
Leiomyosarcoma
Treatment Failure
Radiotherapy
Survival Rate

All Science Journal Classification (ASJC) codes

  • Urology

Cite this

Ballo, M., Zagars, G. K., Pisters, P. W. T., Feig, B. W., Patel, S. R., & Von Eschenbach, A. C. (2001). Spermatic cord sarcoma: Outcome, patterns of failure and management. Journal of Urology, 166(4), 1306-1310. https://doi.org/10.1016/S0022-5347(05)65758-8

Spermatic cord sarcoma : Outcome, patterns of failure and management. / Ballo, Matthew; Zagars, Gunar K.; Pisters, Peter W.T.; Feig, Barry W.; Patel, Shreyaskumar R.; Von Eschenbach, Andrew C.

In: Journal of Urology, Vol. 166, No. 4, 01.01.2001, p. 1306-1310.

Research output: Contribution to journalArticle

Ballo, M, Zagars, GK, Pisters, PWT, Feig, BW, Patel, SR & Von Eschenbach, AC 2001, 'Spermatic cord sarcoma: Outcome, patterns of failure and management', Journal of Urology, vol. 166, no. 4, pp. 1306-1310. https://doi.org/10.1016/S0022-5347(05)65758-8
Ballo M, Zagars GK, Pisters PWT, Feig BW, Patel SR, Von Eschenbach AC. Spermatic cord sarcoma: Outcome, patterns of failure and management. Journal of Urology. 2001 Jan 1;166(4):1306-1310. https://doi.org/10.1016/S0022-5347(05)65758-8
Ballo, Matthew ; Zagars, Gunar K. ; Pisters, Peter W.T. ; Feig, Barry W. ; Patel, Shreyaskumar R. ; Von Eschenbach, Andrew C. / Spermatic cord sarcoma : Outcome, patterns of failure and management. In: Journal of Urology. 2001 ; Vol. 166, No. 4. pp. 1306-1310.
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abstract = "Purpose: We evaluate the outcome, clarify the patterns of failure and suggest treatment strategies for sarcoma in the spermatic cord. Materials and Methods: Between 1956 and 1998, 32 patients with spermatic cord sarcoma were treated at M. D. Anderson Cancer Center. A retrospective review of disease outcome, patterns of relapse and patient survival was performed. Results: Histological subtypes of sarcoma were malignant fibrous histiocytoma in 12 patients, leiomyosarcoma in 6, liposarcoma in 8 and other subtypes in 6. All except 2 patients underwent radical orchiectomy with or without additional resection to achieve negative margins. Margins were microscopically negative in 29 cases and positive in 3. There were 3 patients who received adjuvant radiation to the surgical site. With a median followup of 9 years the 10 and 15-year actuarial local control, distant metastasis-free and overall survival rates were 72{\%} and 61{\%}, 85{\%} and 85{\%}, and 63{\%} and 52{\%}, respectively. The major pattern of failure was local recurrence that occurred in 8 of the 12 patients in whom disease relapsed and was the sole site of relapse in 7. Pelvic nodes had relapsed in 2 patients and para-aortic nodes in 1. Hematogenous metastases had developed in 4 patients. Of the 7 cases of disease that recurred locally only 3 were salvaged. No relapse occurred in the 3 patients treated with combined surgery and radiation. Conclusions: Spermatic cord sarcoma has a high propensity for local recurrence after surgery. Nodal relapse is less frequent than commonly believed. Because of the relatively high local failure rate seen in surgery alone and durable local control noted in 3 patients treated with surgery plus radiotherapy, combined modality treatment should be considered in those with spermatic cord sarcoma who are believed to be ar high risk for local failure.",
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