THE JOURNAL OF UROLOGY

Vol. 195, No. 4S, Supplement, Monday, May 9, 2016

e843

PD34-12
IMPORTANCE OF WIDE RE-RESECTION IN ADULT SPERMATIC
CORD SARCOMAS: REPORT ON ONCOLOGIC OUTCOMES AT A
SINGLE INSTITUTION
Katie Murray*, Emily Vertosick, Massimiliano Spaliviero,
Joseph Mashni, Daniel Sjoberg, Harry Herr, Paul Russo,
Jonathan Coleman, New York, NY

Source of Funding: None

PD34-11
CLINICOPATHOLOGIC FEATURES AND PROGNOSTIC FACTORS
IN PATIENTS WITH PENILE CANCER WHO UNDERWENT
INGUINAL LYMPHADENECTOMY WITH HISTOLOGICALLY
NEGATIVE LYMPH NODES
^nio Zequi, Gustavo Guimara
~es,
Giuliano Aita*, Teresina, Brazil; Ste
~o Paulo, Brazil
Walter da Costa, Isabela Cunha, Fernando Soares, Sa
INTRODUCTION AND OBJECTIVES: The presence and
extent of involvement of inguinal lymph nodes (LN) are the most
important prognostic factor for the survival of patients with penile cancer
(PC). However, despite the fact that the patients tested negative LN
suggests a quite favorable evolution comparing to those with positive
LN, the absence of lymph node metastasis is not an absolute guarantee
of treatment success. A portion of these patients had locoregional
recurrence or even tumor progression. The inuence of the factors
related to the primary tumor in the evolution of patients with histologically negative LN in PC is unknown. This study aims to study the clinicopathologic characteristics of this population or their respective
primary tumors and prognostic factor for overall survival (OS), cancer
specic survival (CSS) and disease-free survival (DFS).
METHODS: A retrospective analysis of medical records of 279
patients with PC treated at the Department of Pelvic Surgery, Hospital
~o Paulo - SP) between 1953 and 2012 underwent
AC Camargo ( Sa
amputation and histologically- negative LN ( pN0 group, 165 patients) or
clinically-negative and followed for a period minimum of 3 years (cN0
group, 96 patients). The pathological material was reviewed by expert
pathologists. The clinicopathological variables in addition to the standard invasive front according to the criteria and modied by Anneroth
and Bryne.
RESULTS: 67 deaths occurred during the follow-up in cN0
Group, 6 of them occurred by cancer. The 10 year-OS, CSS and DFS
were respectively 59.7%, 96.4% and 95.2%. In this group (cN0), the
presence of high grade tumor was independent risk factor of death by
cancer (hazard ratio (HR) 2.05; p0,006) and risk of cancer recurrence
(HR 1.44; p0,01). 44 deaths occurred during follow-up in pN0 group,
12 of them occurred by cancer. The 10 year-OS, CSS and DFS were
respectively 52.7%, 87.1% and 86%. The front invasion inltrating was
associated with a lower CSS ( p 0.027 ) and lower DFS (p 0.019 ) in
pN0 group in univariate analysis.
CONCLUSIONS: In patients with histologically negative LN the
pattern of invasion inltrating was associated with increased tumor
recurrence and cancer-specic mortality. The presence of high-grade
tumor was an independent unfavorable prognostic factor for DFS and
for CSS in patients with clinically negative LN. The cN0 patients had
better 10-year-OS, CSS and DFS than the pN0 ones and tended to
present more favorable demographic, clinical and pathological
characteristics.
Source of Funding: None

INTRODUCTION AND OBJECTIVES: We report on a single

cancer centers 30-year experience with the rare disease of sarcoma of
the spermatic cord. The objective of this study was to evaluate the
outcomes of surgery, including surgery with adjuvant radiation, on
survival.
METHODS: We reviewed records of 81 consecutive patients
treated between 1981 and 2011 at Memorial Sloan Kettering Cancer
Center for spermatic cord sarcoma. We found that 72 patients were
evaluable after excluding those with metastatic disease and those not
undergoing surgical intervention. Recurrence-free and cancer-specic
survival was calculated for patients who underwent wide surgical reresection within 5 months of diagnosis. Univariate Cox regression
models were constructed to assess the relationship of age, tumor size,
tumor histology, adjuvant radiation, and wide surgical re-resection with
recurrence and death. The Kaplan-Meier method was used to estimate
recurrence and survival probabilities.
RESULTS: Median patient age at rst surgery was 60 years
(IQR 50e68). High-grade tumors were evident in 46 patients (64%).
Wide surgical re-resection was performed in 67% (48) of patients within
5 months of diagnosis. A signicant improvement in recurrence-free
survival was identied in those undergoing wide surgical re-resection
(HR 0.16, 95% CI 0.07e0.37; p <0.0001), shown in Figure 1. After
examining possible sources of bias, we found that patients receiving
wide re-resection had higher grade disease but still received an RFS
benet from wide re-resection. Positive surgical margin status at wide
re-resection was strongly associated with both disease recurrence (HR
5.56, 95% CI 1.14, 27.11, p0.034) and death from cancer (HR 6.16,
95% CI 1.25, 30.29, p0.025). We did not observe a signicant difference in recurrence-free or cancer-specic survival between patients
who received adjuvant radiation therapy and those who did not (p0.4
and p0.9).
CONCLUSIONS: A wide surgical re-resection with negative
margins is effective in the management of patients with spermatic cord
sarcoma and leads to improved recurrence-free survival.

Source of Funding: Sidney Kimmel Center for Prostate and

Urologic Cancers