Importance of wide re-resection in adult spermatic cord sarcomas: Report on oncologic outcomes at a single institution Journal Article

Authors: Murray, K. S.; Vertosick, E. A.; Spaliviero, M.; Mashni, J. W. Jr; Sjoberg, D. D.; Alektiar, K. M.; Herr, H. W.; Russo, P.; Coleman, J. A.
Article Title: Importance of wide re-resection in adult spermatic cord sarcomas: Report on oncologic outcomes at a single institution
Abstract: 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. © 2018 Wiley Periodicals, Inc.
Keywords: adult; cancer chemotherapy; cancer survival; aged; middle aged; cancer surgery; survival rate; retrospective studies; major clinical study; overall survival; clinical trial; mortality; salvage therapy; cancer patient; follow up; follow-up studies; tumor localization; neoplasm recurrence, local; tumor volume; pathology; retrospective study; histology; cancer mortality; sarcoma; cancer specific survival; tumor recurrence; recurrent disease; spindle cell; leiomyosarcoma; malignant fibrous histiocytoma; adjuvant radiotherapy; patient referral; embryonal rhabdomyosarcoma; liposarcoma; recurrence free survival; surgical margin; wide excision; re-resection; male genital tract tumor; humans; prognosis; human; male; female; priority journal; article; spermatic cord; spermatic cord sarcoma; myosarcoma; margins of excision; negative margins; wide re resection
Journal Title: Journal of Surgical Oncology
Volume: 117
Issue: 7
ISSN: 0022-4790
Publisher: Wiley Blackwell  
Date Published: 2018-06-01
Start Page: 1464
End Page: 1468
Language: English
DOI: 10.1002/jso.25016
PUBMED: 29473967
PROVIDER: scopus
PMCID: PMC6028307
Notes: Article -- Export Date: 1 August 2018 -- Source: Scopus
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MSK Authors
  1. Jonathan Coleman
    193 Coleman
  2. Paul Russo
    460 Russo
  3. Kaled M Alektiar
    253 Alektiar
  4. Daniel D. Sjoberg
    141 Sjoberg
  5. Harry W Herr
    411 Herr
  6. Joseph Wadie Mashni
    10 Mashni
  7. Katie S Murray
    14 Murray