Long‐term oncological outcomes of patients with paratesticular sarcoma

Abstract

Objectives To present long‐term oncological outcomes of patients with paratesticular sarcoma treated by a multidisciplinary team. Patients and methods Patients managed at the Princess Margaret Cancer Centre, between 1990 and 2012, were analysed. A sarcoma expert performed central pathology review. Kaplan–Meier graphs compared local recurrence (LR), metastasis, and overall survival (OS) of patients treated with hemiscrotectomy vs those who did not. Univariable Cox proportional hazards analysis was performed to delineate predictors of LR, metastasis, and OS. Results Overall, 51 patients with a median (interquartile range) follow‐up of 132 (51.6–226.8) months were analysed. At presentation, 92.2% (47 patients) had localised disease. Only five patients (9.8%) had undergone initially planned hemiscrotectomy. Completion and salvage hemiscrotectomy was performed in 25 (54.3%) and seven (15.2%) patients, respectively. Recurrence and metastasis occurred in 12 (25.5%) and 10 patients (19.6%), respectively. At the last follow‐up, 21.6% (11 patients) had died, with eight dying from their disease. Kaplan–Meyer graphs demonstrated that hemiscrotectomy improved LR (median not reached vs 62.4 months, log‐rank P = 0.008) and OS (median not reached vs 168 months, log‐rank P = 0.081). Univariable analysis found hemiscrotectomy to be associated with a lower LR rate (hazard ratio [HR] 0.21, P = 0.02), whilst positive margins at initial surgery were associated with increased LR (HR 4.81, P = 0.047). No metastasis predictors were found, but age (HR 1.04, 95% confidence interval [CI] 1.0–1.08; P = 0.02) and non‐localised disease at presentation (HR5.17, 95% CI 1.33–20.06; P = 0.017) were associated with worse OS. Conclusion Paratesticular sarcoma is a rare tumour, predominantly manifesting as localised disease. Most patients receive an initial suboptimal oncological surgery. Improved long‐term outcomes are demonstrated following early hemiscrotectomy.

Giant paratesticular liposarcoma with lung metastases: a case report and review of the literature

“…Urological sarcomas are rare tumors accounting for 2.7% of all soft tissue sarcomas across organs in adult patients [1]. Paratesticular liposarcoma (PTL) is relatively common among the urological sarcomas in the literature [1][2][3][4][5], however, PTL is an extremely rare clinical entity. Based on previous case studies and recent reviews [3][4][5][6][7][8][9], approximately more than 200 cases of PTL have been reported to date.…”

“…Paratesticular liposarcoma (PTL) is relatively common among the urological sarcomas in the literature [1][2][3][4][5], however, PTL is an extremely rare clinical entity. Based on previous case studies and recent reviews [3][4][5][6][7][8][9], approximately more than 200 cases of PTL have been reported to date. PTLs mostly present as a painless, slow-growing inguinal or inguinoscrotal mass [2,3,8,9].…”

“…Based on previous case studies and recent reviews [3][4][5][6][7][8][9], approximately more than 200 cases of PTL have been reported to date. PTLs mostly present as a painless, slow-growing inguinal or inguinoscrotal mass [2,3,8,9]. In general, surgical approaches, including radical orchiectomy with wide local excision and high ligation of the spermatic cord, should be performed in cases of suspected PTL [2][3][4][5].…”

“…PTLs mostly present as a painless, slow-growing inguinal or inguinoscrotal mass [2,3,8,9]. In general, surgical approaches, including radical orchiectomy with wide local excision and high ligation of the spermatic cord, should be performed in cases of suspected PTL [2][3][4][5]. However, 1-5% of patients with paratesticular sarcoma, including PTL, present with metastatic disease [2][3][4][5].…”

“…In general, surgical approaches, including radical orchiectomy with wide local excision and high ligation of the spermatic cord, should be performed in cases of suspected PTL [2][3][4][5]. However, 1-5% of patients with paratesticular sarcoma, including PTL, present with metastatic disease [2][3][4][5]. Their extremely low incidence hampers our understanding of metastatic PTLs in terms of clinical presentations, effective chemotherapeutic regimens, and prognosis.…”