Salah Samer, Salem Ahmed
Department of Medical Oncology, King Hussein Cancer Center, Queen Rania Street, Al-Jubeiha, Amman 11941, Jordan.
Department of Radiation Oncology, King Hussein Cancer Center, Queen Rania Street, Al-Jubeiha, Amman 11941, Jordan.
ISRN Oncol. 2014 Jan 20;2014:412527. doi: 10.1155/2014/412527. eCollection 2014.
Background. The aim of this systematic review is to attempt to provide a descriptive analysis for cases of synovial sarcoma (SS) arising in the mediastinum and to analyze prognostic factors. Methods. We performed PubMed database search in July 2013. Twenty-two studies, which included 40 patients, form the basis of this review. Demographic and disease-related factors were analyzed for possible influence on survival. Findings were compared with extremity SS studies reported in literature. Results. Sixteen cases (40%) presented with locally advanced unresectable disease, 2 (5%) with metastatic disease, and 22 (55%) with localized resectable disease. Median tumor size was 11 cm (range: 5-20 cm). Thirty patients were assessable for survival and had a 5-year OS of 36%. Completeness of resection was the only factor associated with significant improvement in OS (5-year survival of 63% and 0% in favor of complete resection, P = 0.003). Conclusion. Mediastinal SS is associated with poor prognosis as more cases are diagnosed at an advanced stage and with larger tumor size compared to extremity SS. Complete surgical resection is the only identified factor associated with better prognosis and may result in survival outcomes that are comparable with those for localized SS of the extremity.
背景。本系统评价的目的是尝试对纵隔滑膜肉瘤（SS）病例进行描述性分析，并分析预后因素。方法。我们于2013年7月在PubMed数据库进行检索。22项研究，共纳入40例患者，构成了本评价的基础。分析人口统计学和疾病相关因素对生存的可能影响。将结果与文献报道的肢体SS研究进行比较。结果。16例（40%）表现为局部晚期不可切除疾病，2例（5%）为转移性疾病，22例（55%）为局限性可切除疾病。肿瘤中位大小为11 cm（范围：5 - 20 cm）。30例患者可评估生存情况，5年总生存率为36%。手术切除的完整性是与总生存率显著改善相关的唯一因素（完整切除组5年生存率为63%，未完整切除组为0%，P = 0.003）。结论。纵隔SS预后较差，因为与肢体SS相比，更多病例在晚期被诊断出来，且肿瘤更大。完整的手术切除是唯一确定的与较好预后相关的因素，可能导致与肢体局限性SS相当的生存结果。
