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Optimal surgical treatment for paratesticular leiomyosarcoma: Retrospective analysis of 217 reported cases

Paratesticular leiomyosarcoma (LMS) is a rare tumor. Conventionally, tumor resection by high inguinal orchiectomy is performed as the preferred treatment approach for paratesticular sarcoma. On the other hand, testis-sparing surgery has recently attracted attention as a less-invasive treatment option for paratesticular sarcoma. | Kamitani et al. BMC Cancer 2022 22 15 https doi.org 10.1186 s12885-021-09122-7 RESEARCH Open Access Optimal surgical treatment for paratesticular leiomyosarcoma retrospective analysis of 217 reported cases Rei Kamitani Kazuhiro Matsumoto Toshikazu Takeda Ryuichi Mizuno and Mototsugu Oya Abstract Background Paratesticular leiomyosarcoma LMS is a rare tumor. Conventionally tumor resection by high ingui- nal orchiectomy is performed as the preferred treatment approach for paratesticular sarcoma. On the other hand testis-sparing surgery has recently attracted attention as a less-invasive treatment option for paratesticular sarcoma. However the prognostic predictors and optimal treatment strategy for paratesticular LMS remain unclear because of its rarity. In this study we systematically reviewed previously reported cases of paratesticular LMS to evaluate the prognostic factors and establish the optimal treatment strategy. Methods A systematic search of Medline Web of Science Embase and Google was performed to find articles describing localized paratesticular LMS published between 1971 and 2020 in English. The final cohort included 217 patients in 167 articles. The starting point of this study was the time of definitive surgical treatment and the end point was the time of local recurrence LR distant metastasis DM and disease-specific mortality. Results Patients with cutaneous LMS had a slightly better LR-free survival DM-free survival and disease-specific sur- vival than those with subcutaneous LMS p 0.745 p 0.033 and p 0.126 respectively . Patients with higher grade tumors had a significantly higher risk of DM and disease-specific mortality Grade 3 vs Grade 1 p Kamitani et al. BMC Cancer 2022 22 15 Page 2 of 9 Among genitourinary STSs leiomyosarcoma LMS is described in different reports were treated as a single one of the common histological subtypes that sometimes case. All searches were conducted independently by two develops in the paratesticular region 2 4 . .