THE MANAGEMENT OF SPERMATIC CORD SARCOMA

BACKGROUND, Between April 1963 and July 1991, 18 patients were treated for spermatic cord sarcoma. The histologic subtype distribution was: 7 leiomyosarcoma, 7 liposarcoma, 2 malignant fibrous histiocytoma, and 1 mesothelioma. METHODS, All patients underwent surgical resection: 1 6 radical orchiectomy and local excision. Nine were treated with orchi ectomy alone, and 9 received adjuvant radiation. The radiation fields encompassed the ipsilateral iliac and inguinal lymph nodes, vas defere ns, and hemiscrotum in 7 patients, and iliac and inguinal lymph nodes in 2 patients. RESULTS, The actuarial 5 and 8-year disease free surviv als for the 18 patients were 77% and 58%, with an overall survival of 78% and 70%, respectively. The 5 and 8-year locoregional control rates were 82% and 61%. Five of 9 patients treated with surgery alone devel oped locoregional recurrence while none of the nine who had adjuvant r adiation relapsed. The median follow-up for the irradiated group, howe ver, was shorter (123 vs 63 months) and staging studies more complete. These potential biases are discussed. CONCLUSION, In this series, rel apse was common after orchiectomy alone. Adjuvant radiation therapy ma y reduce the incidence of locoregional failure.