Organ-sparing Surgery in Treating Patients with Liposarcoma of the Spermatic Cord: Institutional Experience and Pooled Analysis

Background: Liposarcoma of the spermatic cord is rare and frequently misdiagnosed. The standardtherapeutic approach has been radical inguinal orchiectomy with wide local resection of surrounding softtissues. The current trend of organ preservation in the treatment of several cancers has started to evolve. Hereinwe present our testis-sparing surgery experience in the treatment of spermatic cord liposarcoma and a pooledanalysis on this topic. Materials and
Methods: Clinical information from patient receiving organ-sparing surgerywas described. Clinical studies evaluating this issue were identified by using a predefined search strategy, e.g.,Pubmed database with no restriction on date of published papers. The literature search used the followingterms: epidemiology , surgery , chemotherapy , radiotherapy , testis sparing surgery, spermatic cord sarcomas/liposarcomas.
Results: Patient received a complete excision of the lesion, preserving the spermatic cord and thetestis. The final pathological report showed a well differentiated liposarcoma with negative surgical marginsand no signs of local invasion. After 2-year of follow-up, there was no evidence of local recurrence. Since thefirst case reported in 1952, a total of about 200 well-documented spermatic cord liposarcoma cases have beenpublished in English literature. Among these patients, only three instances were reported to have received anorgan-sparing surgery in the treatment of spermatic cord liposarcoma.
Conclusions: Radical inguinal orchiectomyand resection of the tumor with a negative microscopic margin is the recommended treatment for liposarcomaof the spermatic cord. But for small, especially well-differentiated, lesions, testis-sparing surgery might be agood option if an adequate negative surgical margin is assured.