title: Liposarcoma of the Spermatic Cord: Impact of Final Surgical Intervention--An Institutional Experience.
abstract: BACKGROUND
  Paratesticular liposarcomas are almost always mistakenly diagnosed as inguinal hernias subsequently followed by inadequate operation.
  
  
  METHODS
  14 consecutive patients with paratesticular liposarcoma were retrospectively reviewed. Preoperative management was evaluated. Disease-free and overall survival were determined.
  
  
  RESULTS
  In 11 patients primary and in 3 patients recurrent liposarcoma of the spermatic cord were diagnosed. Regarding primary treatment in primary surgical intervention resection was radical (R0) in 7 of 14 (50%) patients, marginal (R1) in 6 (43%) patients, and incomplete with macroscopic residual tumour (R2) in 1 (7%) patient. Primary treatment secondary surgical intervention was performed in 4 patients: resection was radical (R0) in 3 (75%) patients and marginal (R1) in 1 (25%) patient. Regarding secondary treatment in recurrent disease resection was marginal (R1) in 3 patients (100%). Final histologic margins were negative in 10 patients with primary disease (71%) and positive in 4 patients with subsequent recurrent disease. After radical resection disease-free survival rates at 3 years were 100%. Overall survival at 4.5 years (54 (18-180) months) was 64%.
  
  
  CONCLUSIONS
  An incomplete first surgical step increases the number of positive margins leading to local recurrences and adverse prognoses. Aggressive surgery should be attempted to attain 3-dimensional negative margins.
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seylerstrasse 3, 72076 Tübingen, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Bachmann
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seylerstrasse 3, 72076 Tübingen, Germany.
authors.forename: J
authors.initials: J
authors.lastname: Rolinger
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seylerstrasse 3, 72076 Tübingen, Germany.
authors.forename: P
authors.initials: P
authors.lastname: Girotti
authors.affiliation: Department of Oncology II, University Hospital Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, Germany.
authors.forename: H G
authors.initials: HG
authors.lastname: Kopp
authors.affiliation: Department of Oncology II, University Hospital Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, Germany.
authors.forename: K
authors.initials: K
authors.lastname: Heissner
authors.affiliation: Department of Urology, University Hospital Tübingen, Hoppe-Seylerstrasse 3, 72076 Tübingen, Germany.
authors.forename: B
authors.initials: B
authors.lastname: Amend
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seylerstrasse 3, 72076 Tübingen, Germany.
authors.forename: A
authors.initials: A
authors.lastname: Königsrainer
authors.affiliation: Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seylerstrasse 3, 72076 Tübingen, Germany.
authors.forename: R
authors.initials: R
authors.lastname: Ladurner
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018572:Disease-Free Survival; D005834:Genital Neoplasms, Male / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D006801:Humans; D008080:Liposarcoma / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D018365:Neoplasm, Residual / Q000175:diagnosis / Q000401:mortality / Q000601:surgery*; D009919:Orchiectomy / Q000379:methods; D011379:Prognosis; D012189:Retrospective Studies; D013085:Spermatic Cord / Q000473:pathology / Q000601:surgery*; D015996:Survival Rate