title: Adult spermatic cord sarcomas: management and results.
abstract: 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.
authors.affiliation: Department of Urology, Memorial Sloan-Kettering Cancer Center, New York, New York, USA.
authors.forename: Jonathan
authors.initials: J
authors.lastname: Coleman
authors.forename: Murray F
authors.initials: MF
authors.lastname: Brennan
authors.forename: Kaled
authors.initials: K
authors.lastname: Alektiar
authors.forename: Paul
authors.initials: P
authors.lastname: Russo
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D016208:Databases, Factual; D018572:Disease-Free Survival; D005834:Genital Neoplasms, Male / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local; D009367:Neoplasm Staging; D011379:Prognosis; D012509:Sarcoma / Q000188:drug therapy / Q000473:pathology* / Q000601:surgery; D013085:Spermatic Cord / Q000473:pathology* / Q000601:surgery