Sarcomas of the spermatic cord: significance of wide local excision

A respective review was performed of 18 patients presenting with spermatic cord sarcomas over a 28 year period to determine factors predictive of local recurrence and disease-specific survival. Factors assessed at predictors of local recurrence included tumor grade, histology, positive surgical margins, and inadequate excision, defined as scrotal violation or excisional biopsy. In addition to these factors, local recurrence and the presence of hematogenous metastasis were evaluated as predictors of disease-specific survival. Nine patients were originally treated with radical orchiectomy; 2 underwent trans-scrotal orchiectomy; 6 had an excisional biopsy; and 1 had scrotal exploration followed by radical orchiectomy. The presence of positive surgical margins was a significant predictor of early local recurrence on univariate analysis. Local recurrence and the presence of hematogenous metastasis were significant predictors of disease-specific survival on univariate analysis. This emphasizes the importance of radical orchiectomy with local excision in the management of spermatic cord sarcomas.