Koh Kyoung Hwan, Cho Eun Yoon, Kim Dong Wook, Seo Sung Wook
Department of Orthopedic Surgery, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
Orthopedics. 2009 Nov;32(11):824. doi: 10.3928/01477447-20090922-12.
Many studies have described the diversity of synovial sarcoma in terms of its biological characteristics and clinical features. Moreover, much effort has been expended on the identification of prognostic factors because of unpredictable behaviors of synovial sarcomas. However, with the exception of tumor size, published results have been inconsistent. We attempted to identify independent risk factors using survival analysis. Forty-one consecutive patients with synovial sarcoma were prospectively followed from January 1997 to March 2008. Overall and progression-free survival for age, sex, tumor size, tumor location, metastasis at presentation, histologic subtype, chemotherapy, radiation therapy, and resection margin were analyzed, and standard multivariate Cox proportional hazard regression analysis was used to evaluate potential prognostic factors. Tumor size (>5 cm), nonlimb-based tumors, metastasis at presentation, and a monophasic subtype were associated with poorer overall survival. Multivariate analysis showed metastasis at presentation and monophasic tumor subtype affected overall survival. For the progression-free survival, monophasic subtype was found to be only 1 prognostic factor. The study confirmed that histologic subtype is the single most important independent prognostic factors of synovial sarcoma regardless of tumor stage.
许多研究已从生物学特征和临床特征方面描述了滑膜肉瘤的多样性。此外，由于滑膜肉瘤行为不可预测，人们在识别预后因素方面投入了大量精力。然而，除肿瘤大小外，已发表的结果并不一致。我们试图通过生存分析来识别独立危险因素。从1997年1月至2008年3月，对41例连续的滑膜肉瘤患者进行了前瞻性随访。分析了年龄、性别、肿瘤大小、肿瘤位置、初诊时有无转移、组织学亚型、化疗、放疗和手术切缘的总生存率和无进展生存率，并采用标准多变量Cox比例风险回归分析来评估潜在的预后因素。肿瘤大小（>5 cm）、非肢体部位肿瘤、初诊时转移和单相亚型与较差的总生存率相关。多变量分析显示，初诊时转移和单相肿瘤亚型影响总生存率。对于无进展生存率，单相亚型是唯一的预后因素。该研究证实，无论肿瘤分期如何，组织学亚型都是滑膜肉瘤最重要的单一独立预后因素。
