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Primary Spermatic Cord Tumors: Disease Characteristics, Prognostic Factors And Treatment Outcomes.
Dayron Rodríguez1, Aria F. Olumi2
1Harvard Medical School and Harvard School of Public Health, Boston, MA;2Department of Urology, Massachusetts General Hospital, Boston, MA

Introduction: Experience with management of spermatic cord tumors (SCT) is uncommon. Therefore, in order to better elucidate the disease characteristics of SCT we utilized a large population-based cancer registry to characterize the demographic, pathological, treatment characteristics and outcomes.
Materials & Methods: The Surveillance, Epidemiology, and End Results (SEER) database (1973-2007) was queried.
Results: 362 patients were identified with SCT. The annual incidence of SCT was 0.5 cases per 1,000,000, and did not change over time. The most common histologic types were liposarcoma (46%), leiomyosarcoma (20%), histiocytoma (13%), and rhabdomyosarcoma (9%). The median age for diagnosis of rhabdomyosarcomas was (26.3yrs), while for other SCT was (64.7yrs) (p< 0.001), suggesting a different biologic behavior in rhabdomyosarcomas than other SCT's. On multivariate analysis, a worst outcome was associated with an undifferentiated tumor grade, distant stage, positive lymph nodes, and leiomyosarcoma or histiocytoma cell histology. Radiotherapy improved survival in patients with lymph node metastasis (median 81.5 months vs. 120.4, p-value = 0.043), but not in patients without metastasis. Lymphadenectomy made no difference in survival in patients with or without lymph node involvement.
Conclusions:
This series represents the largest cohort of SCT studied to date. While liposarcoma is the most common, leiomyosarcoma and histiocytoma histologic subtypes are the most aggressive. Radiotherapy improves survival in patients with lymph node metastasis; however, lymphadenectomy does not significantly affect survival.


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