Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai Key Laboratory of Stomatology, No. 639, Zhi Zao Ju Road, Shanghai 200011, PR China.
Oral Oncol. 2011 Jul;47(7):671-6. doi: 10.1016/j.oraloncology.2011.04.014. Epub 2011 Jun 8.
To retrospectively review the diagnosis and treatment outcomes of 21 diagnosed with synovial sarcoma (SS) extending to skull base region and identify prognostic factors for local recurrence and distant metastasis. The clinical and pathological records of 21 synovial sarcoma cases involving skull base treated at Department of Oral and Maxillofacial Surgery, Affiliated to Ninth People's Hospital, Shanghai Jiao Tong University, from 2003 to 2008 were reviewed. Parameters including clinical, radiographic, histological findings, and treatment modalities were analyzed. Prognostic factors influencing overall survival, local recurrence, and metastasis were identified. Categorical variables were compared between groups for local recurrence and distant metastasis by using 2-tailed Fisher exact test. The sample consisted of 8 males and 13 females with a median age of 23. 42.9% of cases showed skull base bone erosion with 9.5% of cases presenting intracranial tumor extension. 52.4% of cases died from recurrence or metastasis with a median survival time of 11 months. Orbital involvement, perineural and cranial invasion along with other factors were statistically significant for their impact on overall survival. Local recurrence was associated with tumors located in the infratemporal space (p=0.01), perineural invasion (p=0.001), pathological grade 3 (p=0.005), and tumor size >5 cm (p=0.008). The aggressive behavior of skull base SS and its close proximity to vital structures make the diagnosis and management a challenge. The study reported high local recurrence rates despite surgical and postoperative radiotherapy. Adjuvant chemotherapy did not seem to affect distant metastasis rates.
回顾性分析 21 例累及颅底的滑膜肉瘤（SS）的诊断和治疗结果，确定局部复发和远处转移的预后因素。回顾性分析 2003 年至 2008 年期间上海交通大学附属第九人民医院口腔颌面外科收治的 21 例累及颅底的滑膜肉瘤患者的临床和病理资料。分析了包括临床、影像学、组织学发现和治疗方式在内的参数。确定了影响总生存率、局部复发和转移的预后因素。采用双侧 Fisher 确切检验比较局部复发和远处转移组间的分类变量。样本包括 8 例男性和 13 例女性，中位年龄为 23.42 岁。42.9%的病例有颅底骨侵蚀，9.5%的病例有颅内肿瘤延伸。52.4%的病例因复发或转移而死亡，中位生存时间为 11 个月。眼眶受累、神经周围和颅神经侵犯以及其他因素对总生存率有统计学意义。局部复发与位于颞下间隙的肿瘤（p=0.01）、神经周围侵犯（p=0.001）、病理分级 3 级（p=0.005）和肿瘤大小>5 cm（p=0.008）有关。颅底 SS 的侵袭性行为及其与重要结构的接近性使得诊断和管理具有挑战性。尽管进行了手术和术后放疗，但本研究报告的局部复发率仍然较高。辅助化疗似乎并未影响远处转移率。
