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International Journal of Surgical Oncology
Volume 2016, Article ID 4785394, 5 pages
http://dx.doi.org/10.1155/2016/4785394
Research Article

Liposarcoma of the Spermatic Cord: Impact of Final Surgical Intervention—An Institutional Experience

1Department of General, Visceral and Transplant Surgery, University Hospital Tübingen, Hoppe-Seylerstrasse 3, 72076 Tübingen, Germany
2Department of Oncology II, University Hospital Tübingen, Otfried-Müller-Strasse 10, 72076 Tübingen, Germany
3Department of Urology, University Hospital Tübingen, Hoppe-Seylerstrasse 3, 72076 Tübingen, Germany

Received 31 October 2015; Revised 14 February 2016; Accepted 28 March 2016

Academic Editor: Kazuhiro Yoshida

Copyright © 2016 R. Bachmann et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. Paratesticular liposarcomas are almost always mistakenly diagnosed as inguinal hernias subsequently followed by inadequate operation. Methods. 14 consecutive patients with paratesticular liposarcoma were retrospectively reviewed. Preoperative management was evaluated. Disease-free and overall survival were determined. Results. In 11 patients primary and in 3 patients recurrent liposarcoma of the spermatic cord were diagnosed. Regarding primary treatment in primary surgical intervention resection was radical (R0) in 7 of 14 (50%) patients, marginal (R1) in 6 (43%) patients, and incomplete with macroscopic residual tumour (R2) in 1 (7%) patient. Primary treatment secondary surgical intervention was performed in 4 patients: resection was radical (R0) in 3 (75%) patients and marginal (R1) in 1 (25%) patient. Regarding secondary treatment in recurrent disease resection was marginal (R1) in 3 patients (100%). Final histologic margins were negative in 10 patients with primary disease (71%) and positive in 4 patients with subsequent recurrent disease. After radical resection disease-free survival rates at 3 years were 100%. Overall survival at 4.5 years (54 (18–180) months) was 64%. Conclusion. An incomplete first surgical step increases the number of positive margins leading to local recurrences and adverse prognoses. Aggressive surgery should be attempted to attain 3-dimensional negative margins.