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Liposarcoma of the Spermatic Cord: Impact of Final Surgical Intervention-An Institutional Experience


Affiliations
1 Department of General, Visceral and Transplant Surgery, University Hospital Tubingen, Hoppe-Seylerstrasse 3, 72076 Tubingen, Germany
2 Department of Oncology II, University Hospital Tubingen, Otfried-Muller-Strasse 10, 72076 Tubingen, Germany
3 Department of Urology, University Hospital Tubingen, Hoppe-Seylerstrasse 3, 72076 Tubingen, Germany
 

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 interventionwas 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%. Conclusion:. 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.
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  • Liposarcoma of the Spermatic Cord: Impact of Final Surgical Intervention-An Institutional Experience

Abstract Views: 95  |  PDF Views: 0

Authors

R. Bachmann
Department of General, Visceral and Transplant Surgery, University Hospital Tubingen, Hoppe-Seylerstrasse 3, 72076 Tubingen, Germany
J. Rolinger
Department of General, Visceral and Transplant Surgery, University Hospital Tubingen, Hoppe-Seylerstrasse 3, 72076 Tubingen, Germany
P. Girotti
Department of General, Visceral and Transplant Surgery, University Hospital Tubingen, Hoppe-Seylerstrasse 3, 72076 Tubingen, Germany
H. G. Kopp
Department of Oncology II, University Hospital Tubingen, Otfried-Muller-Strasse 10, 72076 Tubingen, Germany
K. Heissner
Department of Oncology II, University Hospital Tubingen, Otfried-Muller-Strasse 10, 72076 Tubingen, Germany
B. Amend
Department of Urology, University Hospital Tubingen, Hoppe-Seylerstrasse 3, 72076 Tubingen, Germany
A. Konigsrainer
Department of General, Visceral and Transplant Surgery, University Hospital Tubingen, Hoppe-Seylerstrasse 3, 72076 Tubingen, Germany
R. Ladurner
Department of General, Visceral and Transplant Surgery, University Hospital Tubingen, Hoppe-Seylerstrasse 3, 72076 Tubingen, Germany

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 interventionwas 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%. Conclusion:. 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.