Wu Yanan, Bi Wenzhi, Han Gang, Jia Jinpeng, Xu Meng
Department of Bone Tumor, The General Hospital of the People's Liberation Army, Beijing, 100853, China.
World J Surg Oncol. 2017 May 11;15(1):101. doi: 10.1186/s12957-017-1165-9.
This study aimed to explore the clinical efficacy of neoadjuvant chemotherapy combined with surgery in primary synovial sarcoma of the limbs and trunk through retrospective analysis of patients with primary synovial sarcoma of the limbs and trunk treated by this treatment in our hospital.
A total of 89 patients diagnosed with synovial sarcoma were enrolled in this study between January 2005 and December 2011 in PLA General Hospital. Most of the patients received neoadjuvant chemotherapy combined with operative treatment (84.3%), 10.1% of them received adjuvant chemotherapy combined with operative treatment, and only 5.6% received merely operative treatment. The influence on the prognosis of patients with synovial sarcoma was analyzed by the statistics overall survival (OS), progression-free survival (PFS), local control (LC), and freedom from distant metastasis (FFDM).
The median follow-up time was 68.6 months. The 5-year OS, 5-year PFS, 5-year LC, and 5-year FFDM of the patients were 80.2, 60.5, 78.8, and 80.8%, respectively. The OS of the patients with a tumor size >5 cm was lower (91.4 vs 73.1%, P < 0.05). Besides, the OS and FFDM of neoadjuvant chemotherapy were better than those of adjuvant chemotherapy (84.5 vs 55.6%, P = 0.015, and 83.8 vs 55.6%, P = 0.028, respectively). However, there was no significant difference in the LC and PFS.
Neoadjuvant chemotherapy was beneficial for patients with synovial sarcoma, and it could improve survival time and control distant metastasis. Tumor size was an important factor influencing patients' prognosis.
本研究旨在通过回顾性分析我院采用该治疗方法治疗的肢体及躯干原发性滑膜肉瘤患者，探讨新辅助化疗联合手术治疗肢体及躯干原发性滑膜肉瘤的临床疗效。
2005年1月至2011年12月，解放军总医院共纳入89例诊断为滑膜肉瘤的患者。大多数患者接受新辅助化疗联合手术治疗（84.3%），10.1%的患者接受辅助化疗联合手术治疗，仅5.6%的患者仅接受手术治疗。通过统计总生存期（OS）、无进展生存期（PFS）、局部控制率（LC）和无远处转移生存率（FFDM）分析对滑膜肉瘤患者预后的影响。
中位随访时间为68.6个月。患者的5年总生存率、5年无进展生存率、5年局部控制率和5年无远处转移生存率分别为80.2%、60.5%、78.8%和80.8%。肿瘤大小>5 cm的患者总生存率较低（91.4%对73.1%，P<0.05）。此外，新辅助化疗的总生存率和无远处转移生存率优于辅助化疗（分别为84.5%对55.6%，P=0.015；83.8%对55.6%，P=0.028）。然而，局部控制率和无进展生存率无显著差异。
新辅助化疗对滑膜肉瘤患者有益，可提高生存时间并控制远处转移。肿瘤大小是影响患者预后的重要因素。
