Organ-sparing Surgery in Treating Patients with Liposarcoma of the Spermatic Cord: Institutional Experience and Pooled Analysis.
BACKGROUND
Liposarcoma of the spermatic cord is rare and frequently misdiagnosed. The standard therapeutic approach has been radical inguinal orchiectomy with wide local resection of surrounding soft tissues. The current trend of organ preservation in the treatment of several cancers has started to evolve. Herein we present our testis-sparing surgery experience in the treatment of spermatic cord liposarcoma and a pooled analysis on this topic.


METHODS
Clinical information from patient receiving organ-sparing surgery was described. Clinical studies evaluating this issue were identified by using a predefined search strategy, e.g., Pubmed database with no restriction on date of published papers. The literature search used the following terms: epidemiology , surgery , chemotherapy , radiotherapy , testis sparing surgery, spermatic cord sarcomas/ liposarcomas.


RESULTS
Patient received a complete excision of the lesion, preserving the spermatic cord and the testis. The final pathological report showed a well differentiated liposarcoma with negative surgical margins and no signs of local invasion. After 2-year of follow-up, there was no evidence of local recurrence. Since the first case reported in 1952, a total of about 200 well-documented spermatic cord liposarcoma cases have been published in English literature. Among these patients, only three instances were reported to have received an organ-sparing surgery in the treatment of spermatic cord liposarcoma.


CONCLUSIONS
Radical inguinal orchiectomy and resection of the tumor with a negative microscopic margin is the recommended treatment for liposarcoma of the spermatic cord. But for small, especially well-differentiated, lesions, testis-sparing surgery might be a good option if an adequate negative surgical margin is assured.
Department of Urology, the First Affiliated Hospital of Sun Yat-sen University, Guangzhou, China E-mail : shutongxuan@126.com.
Ming-Xin
MX
Cao
Jie
J
Chen
Jun-Long
JL
Zhang
Xin
X
Wei
Yue-You
YY
Liang
D000293:Adolescent; D000328:Adult; D000368:Aged; D018572:Disease-Free Survival; D005834:Genital Neoplasms, Male / Q000601:surgery*; D006801:Humans; D008080:Liposarcoma / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009919:Orchiectomy; D059351:Organ Sparing Treatments / Q000379:methods; D013085:Spermatic Cord / Q000601:surgery*; D013737:Testis; D016896:Treatment Outcome; D055815:Young Adult