晚期滑膜肉瘤患者的预后因素及治疗：单中心经验

Prognostic factors and treatment of patients with advanced synovial sarcoma: A single-center experience.

作者信息

Ates O, Aksoy S, Yeter H, Sunar V, Kertmen N, Dizdar O, Turker A, Kars A

机构信息

Department of Medical Oncology, Hacettepe University Cancer Institute, Ankara, Turkey.

Department of Internal Medicine, Hacettepe University Cancer Institute, Ankara, Turkey.

出版信息

Indian J Cancer. 2017 Jan-Mar;54(1):321-325. doi: 10.4103/ijc.IJC_169_17.

DOI:10.4103/ijc.IJC_169_17

PMID:29199714

Abstract

BACKGROUND

Synovial sarcoma (SS) is a malignant mesenchymal tumor, which comprises 5%-10% of all the sarcomas. There is insufficient information on prognostic factors and salvage treatments of advanced SS. In this study, we aimed to further clarify the clinicopathological features, prognostic factors, and treatment modalities in advanced SS.

MATERIALS AND METHODS

A total of 45 SS patients followed up between 2001 and 2015 at our cancer institute, Department of Medical Oncology, were retrospectively evaluated. Eleven patients were initially metastatic, and remaining patients developed metastasis or became inoperable due to locally advanced disease. Overall survival was evaluated by Kaplan-Meier analysis.

RESULTS

The median age of patients was 37 (17-70) years and 60% (n = 26) of them were female. SS was most commonly localized in the lower extremity and abdomen-pelvis (29% and 29%, respectively). Median follow-up time was 33 (6-175) months. Patients were treated with a median of two (1-5) line chemotherapies at metastatic stage. Ifosfamide plus adriamycin (IMA) (49%, n = 22) and cisplatin-etoposide (13%, n = 6) were the most often used chemotherapy regimen as first line in metastatic stage. Partial response was obtained in 32% of the patients treated with IMA chemotherapy. Furthermore, median progression-free survival was 6 (1-123) months. Median survival of metastatic stage at diagnosis or in follow-up was 21 months (14-27) and 21 (12-29) months (P = 0.53), respectively. Most metastatic locations were lung (75%) and bone. Factors influencing survival at metastatic stage were evaluated; statistically significant longer survival was observed in patients with lung metastasis, primary tumor size smaller than 10 cm, patients who underwent surgery for the metastasis, and development-to-metastasis period longer than 12 months.

CONCLUSION

Median survival of patients in metastatic stage SS was 21 months. Lung was the most common metastatic site.

摘要

背景

滑膜肉瘤（SS）是一种恶性间叶组织肿瘤，占所有肉瘤的5%-10%。关于晚期SS的预后因素和挽救治疗的信息不足。在本研究中，我们旨在进一步阐明晚期SS的临床病理特征、预后因素和治疗方式。

材料与方法

对2001年至2015年期间在我院肿瘤内科随访的45例SS患者进行回顾性评估。11例患者初诊时即有转移，其余患者因局部晚期疾病出现转移或无法手术。采用Kaplan-Meier分析评估总生存期。

结果

患者的中位年龄为37（17-70）岁，其中60%（n=26）为女性。SS最常见于下肢和腹盆腔（分别为29%和29%）。中位随访时间为33（6-175）个月。患者在转移阶段接受的化疗中位次数为两次（1-5次）。异环磷酰胺加阿霉素（IMA）（49%，n=22）和顺铂-依托泊苷（13%，n=6）是转移阶段最常用的一线化疗方案。接受IMA化疗的患者中有32%获得部分缓解。此外，中位无进展生存期为6（1-123）个月。诊断时或随访中转移阶段的中位生存期分别为21个月（14-27）和21（12-29）个月（P=0.53）。大多数转移部位为肺（75%）和骨。评估了影响转移阶段生存的因素；观察到肺转移患者、原发肿瘤大小小于10 cm、接受转移灶手术的患者以及从发病到转移时间超过12个月的患者的生存期在统计学上显著更长。