Iafrate Massimo, Motterle Giovanni, Zaborra Carlotta, Leone Niccolò, Prayer-Galetti Tommaso, Zattoni Filiberto, Guttilla Andrea, Cappellesso Rocco, Dei Tos Angelo Paolo, Rossi Carlo Riccardo, Del Fiore Paolo, Rastrelli Marco, Mocellin Simone
Urology Clinic Department of Surgical, Oncological and Gastroenterological Sciences, University of Padua, Padua, Italy.
Clinica Urologica dell'Ospedale di Camposampiero, Camposampiero, Italy.
Front Surg. 2020 Nov 17;7:566408. doi: 10.3389/fsurg.2020.566408. eCollection 2020.
Spermatic cord sarcomas represent a rare genitourinary malignancy with a challenging diagnostic and therapeutic pathway. Different histotypes have been described and prognostic factors remain poorly defined due to the paucity of data presented in literature. Retrospective chart review of 22 adult patients treated for spermatic cord sarcoma in a single institution in the last 20 years was performed. Clinicopathological characteristics of the tumors were collected with primary and subsequent treatment. Survival analysis was performed in order to identify prognostic factors of disease-specific survival. The median age at diagnosis was 68 years (58-78), the most common histotype was liposarcoma (14/22), and most patients (63.6%) were found to have positive surgical margins after surgery. The 5-year cancer specific survival was 91.3%. Grading ( = 0.480), histotype ( = 0.327), and type of intervention ( = 0.732) were not associated with survival. All patients dead of disease had positive surgical margins ( = 0.172). We report a good prognosis at 5 years. Wide radical resection remains the first and probably the most important step; thus, according also to literature, negative surgical margins should be aimed.
精索肉瘤是一种罕见的泌尿生殖系统恶性肿瘤,其诊断和治疗途径具有挑战性。文献中已描述了不同的组织学类型,但由于数据稀少,预后因素仍未明确界定。对过去20年在单一机构接受精索肉瘤治疗的22例成年患者进行了回顾性病历审查。收集了肿瘤的临床病理特征以及初次和后续治疗情况。进行生存分析以确定疾病特异性生存的预后因素。诊断时的中位年龄为68岁(58~78岁),最常见的组织学类型是脂肪肉瘤(14/22),大多数患者(63.6%)术后手术切缘阳性。5年癌症特异性生存率为91.3%。分级(P=0.480)、组织学类型(P=0.327)和干预类型(P=0.732)与生存无关。所有死于疾病的患者手术切缘均为阳性(P=0.172)。我们报告5年预后良好。广泛根治性切除仍然是首要且可能是最重要的步骤;因此,根据文献,应争取手术切缘阴性。