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Importance of wide re‐resection in adult spermatic cord sarcomas: Report on oncologic outcomes at a single institution
Author(s) -
Murray Katie S.,
Vertosick Emily A.,
Spaliviero Massimiliano,
Mashni Joseph W.,
Sjoberg Daniel D.,
Alektiar Kaled M.,
Herr Harry W.,
Russo Paul,
Coleman Jonathan A.
Publication year - 2018
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.25016
Subject(s) - medicine , hazard ratio , spermatic cord , sarcoma , surgery , univariate analysis , proportional hazards model , cancer , multivariate analysis , confidence interval , pathology
Background and Objectives We evaluated the effect of re‐resection with wide margins (undertaken because initial resection performed elsewhere was incomplete) on survival in patients with spermatic cord sarcoma (SCS). Methods After excluding those with metastatic disease and those not undergoing surgical intervention, the records of 72 consecutive patients treated for SCS between 1981 and 2011 at Memorial Sloan Kettering Cancer Center were reviewed. Recurrence‐free survival (RFS) and cancer‐specific survival were calculated using the Kaplan‐Meier method for comparing between the 48 patients who underwent wide re‐resection (WRR) within 5 months of diagnosis and the 24 who did not. The relationship of age, tumor size, tumor histology, adjuvant radiation, and wide re‐resection with recurrence and death was assessed by univariate Cox regression. Results WRR significantly improved RFS (hazard ratio [HR] 0.16, 95%CI 0.07‐0.37; P < 0.0001), despite the fact that patients receiving WRR had higher‐grade disease. Tumor‐positive margins upon WRR were strongly associated with both disease recurrence (HR 5.56; 95%CI 1.14‐27.11, P = 0.034) and death from cancer (HR 6.16, 95%CI 1.25‐30.29; P = 0.025). Conclusions A WRR with negative margins is effective in the management of patients with SCS and leads to improved RFS.