Owosho Adepitan A, Estilo Cherry L, Rosen Evan B, Yom SaeHee K, Huryn Joseph M, Antonescu Cristina R
Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, United States.
Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, United States.
Oral Oncol. 2017 Mar;66:46-51. doi: 10.1016/j.oraloncology.2016.12.021. Epub 2017 Jan 10.
To determine clinicopathologic factors on survival in patients with head and neck synovial sarcoma.
We retrospectively identified patients with molecularly confirmed synovial sarcomas of the head and neck (SS-HN), either by the presence of SS18-SSX fusion transcript by RT-PCR or SS18 gene rearrangement by FISH, who were managed at our institution over a 20-year period (1996-2015). Kaplan-Meier survival analysis and log-rank test were performed to evaluate variables related to disease specific survival (DSS). Fisher exact test was performed to evaluate variables related to local recurrence.
Thirty-four patients (20 males and 14 females, mean of 31years) with SS18-SSX fusion-positive SS-HN were identified. The parapharyngeal region of the neck was the most common site. The mean tumor size was 4.8cm (0.8-10cm). Two-thirds (n=23) of cases had a monophasic histology. The 2, 5 and 10-year DSS rates were 97%, 79% and 68%. The 5-year DSS rates for the adult/pediatric cohort were 74%/88%. Recurrence showed significant effect on DSS (p=0.021). There was no significant effect on DSS with age, therapy modality, tumor site, surgical margin, tumor size (⩽5cm vs. >5cm) and histopathologic subtype. Tumor site (i.e. skull base/paranasal sinus region) was associated with local recurrence (p=0.003).
In our cohort DSS rate was associated with recurrence. Tumors located in the skull base/paranasal sinus region were associated with a higher rate of local recurrence. Thus appropriate selection of high risk patients who can benefit from multimodality therapies might improve survival.
确定影响头颈部滑膜肉瘤患者生存的临床病理因素。
我们回顾性纳入了在20年期间（1996 - 2015年）于我院接受治疗的分子确诊的头颈部滑膜肉瘤（SS - HN）患者，通过逆转录聚合酶链反应（RT - PCR）检测到SS18 - SSX融合转录本或通过荧光原位杂交（FISH）检测到SS18基因重排来确诊。采用Kaplan - Meier生存分析和对数秩检验来评估与疾病特异性生存（DSS）相关的变量。采用Fisher精确检验来评估与局部复发相关的变量。
共识别出34例SS18 - SSX融合阳性的SS - HN患者（20例男性和14例女性，平均年龄31岁）。颈部咽旁区是最常见的部位。肿瘤平均大小为4.8cm（0.8 - 10cm）。三分之二（n = 23）的病例为单相组织学类型。2年、5年和10年的DSS率分别为97%、79%和68%。成人/儿童队列的5年DSS率分别为74%/88%。复发对DSS有显著影响（p = 0.021）。年龄、治疗方式、肿瘤部位、手术切缘、肿瘤大小（≤5cm与>5cm）和组织病理学亚型对DSS无显著影响。肿瘤部位（即颅底/鼻窦区）与局部复发相关（p = 0.003）。
在我们的队列中，DSS率与复发相关。位于颅底/鼻窦区的肿瘤局部复发率较高。因此，适当选择能从多模式治疗中获益的高危患者可能会提高生存率。
