Du Zhi-ye, Guo Wei, Yang Rong-li, Yan Tai-qiang, Li Da-sen
Musculoskeletal Tumor Center, People's Hospital, Peking University, Beijing 100044, China.
Zhonghua Wai Ke Za Zhi. 2011 Nov;49(11):991-4.
To determine the independent prognostic factors of primary synovial sarcoma.
The clinical data of 52 patients followed up from 66 patients with synovial sarcoma treated between September 1997 and September 2008 was analyzed retrospectively. There were 28 male and 24 female patients aged from 11 to 71 years old. Three and five-year overall survival (OS), recurrence rate and 9 prognostic factors were analyzed in this study. Univariate and multivariate analysis were performed to determine the prognostic factors of OS.
Fifty-two patients were followed up with the follow-up time ranged from 6 to 88 months (median 32 months). The 3-, 5-year overall survival rate and local recurrence rate were 52.8%, 30.3% and 32.7% respectively. Univariate showed tumor size < 5 cm, tumor located at extremities, adequate surgical margin and radical resection combined with radiotherapy had better survival rate (P < 0.05). Multivariate analysis demonstrated that tumor size, primary site and adequate surgical margin were independent prognostic factors for OS. Patients received radical resection combined with radiotherapy have longer median relapse time (25 months) compared with marginal resection combined with radiotherapy (18 months) and single radical resection (12 months). Thirty-five (67%) patients were treated with chemotherapy and seventeen (33%) patients received no chemotherapy for the primary tumor. Treatment with chemotherapy was not associated with an improved OS (P = 0.52).
The independent prognostic factors of synovial sarcoma are tumor size, primary site and adequate surgical margin. Doxorubicin and ifosfamide based chemotherapy was not associated with an improved OS in patients with synovial sarcoma. Radical resection combined with radiotherapy can best control local condition.
确定原发性滑膜肉瘤的独立预后因素。
回顾性分析1997年9月至2008年9月间治疗的66例滑膜肉瘤患者中52例的随访临床资料。患者年龄11至71岁，男性28例，女性24例。本研究分析了3年和5年总生存率（OS）、复发率及9个预后因素。采用单因素和多因素分析确定OS的预后因素。
52例患者获得随访，随访时间6至88个月（中位时间32个月）。3年、5年总生存率及局部复发率分别为52.8%、30.3%和32.7%。单因素分析显示肿瘤大小<5 cm、肿瘤位于四肢、手术切缘足够及根治性切除联合放疗的生存率较好（P<0.05）。多因素分析表明肿瘤大小、原发部位及手术切缘足够是OS的独立预后因素。根治性切除联合放疗的患者中位复发时间（25个月）长于边缘性切除联合放疗（18个月）及单纯根治性切除（12个月）。35例（67%）患者接受了化疗，17例（33%）患者未接受针对原发肿瘤的化疗。化疗与OS改善无关（P=0.52）。
滑膜肉瘤的独立预后因素为肿瘤大小、原发部位及手术切缘足够。基于阿霉素和异环磷酰胺的化疗与滑膜肉瘤患者OS改善无关。根治性切除联合放疗能最佳控制局部情况。
