Yaser Sameer, Salah Samer, Al-Shatti Marwa, Abu-Sheikha Areej, Shehadeh Ahmad, Sultan Iyad, Salem Ahmad, Sughayer Maher, Al-Loh Shaymaa, Al-Mousa Abdelatif
Department of Medical Oncology, King Hussein Cancer Center, Al-Jubeiha, Amman, 11941, Jordan,
Med Oncol. 2014 Jun;31(6):958. doi: 10.1007/s12032-014-0958-8. Epub 2014 Apr 26.
Synovial sarcoma is a rare type of sarcoma with poor prognosis. Data on relevant prognostic factors are inconsistent. The objective of this study was to determine the independent prognostic factors that govern local recurrence, distant metastasis and overall survival. A retrospective analysis of 51 patients treated for localized synovial sarcoma at a single institution by a multidisciplinary/multimodality approach over a period of 12 years. Patients, tumor and treatment characteristics were collected including age, sex, tumor site, location, depth, size, status of margins, histology subtype and involvement of bone or lymph nodes. Type of surgery, adjuvant chemotherapy and radiotherapy were also examined. The endpoints analyzed were local recurrence-free survival (LRFS), metastasis-free survival (MFS) and overall survival (OS). Median age of patients was 26 years (range 3-64 years) with 73 % above the age of 20 year. All patients received surgery, 57 % received adjuvant radiotherapy and 45 % adjuvant chemotherapy. The median survival was 111 months, and 5-year OS was 73 %. Deep seatedness of the tumor was linked to OS as the only independent risk factor. Twelve patients had local recurrence, and the 5-year LRFS was 61 %. Multivariate analysis determined negative margins and adjuvant radiotherapy as independent predicting factors for LRFS. Five-year MFS was 48 %; multivariate analysis identified monophasic subtype and site other than lower extremity as the only independent factors associated with inferior MFS. The most important factors that govern LRFS and MFS are negative margins and adjuvant radiotherapy for LRFS and tumor histology and site for MFS, while deep seatedness of the tumor is the sole independent factor that governs OS.
滑膜肉瘤是一种预后较差的罕见肉瘤类型。关于相关预后因素的数据并不一致。本研究的目的是确定影响局部复发、远处转移和总生存期的独立预后因素。对一家机构在12年期间采用多学科/多模式方法治疗的51例局限性滑膜肉瘤患者进行回顾性分析。收集了患者、肿瘤和治疗特征，包括年龄、性别、肿瘤部位、位置、深度、大小、切缘状态、组织学亚型以及骨骼或淋巴结受累情况。还检查了手术类型、辅助化疗和放疗情况。分析的终点指标为无局部复发生存期（LRFS）、无转移生存期（MFS）和总生存期（OS）。患者的中位年龄为26岁（范围3 - 64岁），73%的患者年龄超过20岁。所有患者均接受了手术，57%的患者接受了辅助放疗，45%的患者接受了辅助化疗。中位生存期为111个月，5年总生存率为73%。肿瘤的深部位置是影响总生存期的唯一独立危险因素。12例患者出现局部复发，5年无局部复发生存率为61%。多因素分析确定切缘阴性和辅助放疗是无局部复发生存期的独立预测因素。5年无转移生存率为48%；多因素分析确定单相亚型和下肢以外的部位是与较差无转移生存期相关的唯一独立因素。影响无局部复发生存期和无转移生存期的最重要因素，对于无局部复发生存期是切缘阴性和辅助放疗，对于无转移生存期是肿瘤组织学和部位，而肿瘤的深部位置是影响总生存期的唯一独立因素。
