Department of Orthopedic Surgery, The Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan
Department of Orthopedic Surgery, The Cancer Institute Hospital of The Japanese Foundation for Cancer Research, Tokyo, Japan.
Anticancer Res. 2020 Feb;40(2):1029-1034. doi: 10.21873/anticanres.14038.
The role of neoadjuvant chemotherapy for localized synovial sarcoma is still controversial. This study aimed to explore the influence of neoadjuvant chemotherapy combined with surgery in localized synovial sarcoma through analysis of our hospital's patient records.
A total of 122 patients diagnosed with synovial sarcoma were enrolled in this study from January 1980 to December 2016 at the Cancer Institute Hospital of The Japanese Foundation for Cancer Research. The impact of neoadjuvant chemotherapy on overall survival was assessed to show how clinicopathological factors (e.g. age, tumor size, treatment, dose intensity, pathological pattern and histological grading) influenced patient prognosis.
Among 106 patients, 76 (71.7%) received neoadjuvant chemotherapy and 30 (28.3%) did not. The median follow-up was 39.2 (range=12-286) months. The 5-year and 10-year overall survival rates were 65.4% and 58.4% respectively. The tumor size and histological grade influenced the patient's overall survival (p<0.05). Among the patients with grade 2 tumor, tumor size did not influence prognosis. Neoadjuvant chemotherapy improved the overall survival of patients who had grade 3 tumors.
Treatment with neoadjuvant chemotherapy proved beneficial for high-risk patients with grade 3 synovial sarcoma but was not effective for those with low-risk and grade 2 tumor. Tumor size and histological grade were important factors in patient prognosis but had no connection with pathological patterns.
新辅助化疗在局限性滑膜肉瘤中的作用仍存在争议。本研究旨在通过分析我院患者的病历，探讨新辅助化疗联合手术在局限性滑膜肉瘤中的影响。
本研究共纳入 1980 年 1 月至 2016 年 12 月在日本癌症基金会癌症研究所诊断为滑膜肉瘤的 122 例患者。评估新辅助化疗对总生存率的影响，以显示临床病理因素（如年龄、肿瘤大小、治疗、剂量强度、病理模式和组织学分级）如何影响患者预后。
在 106 例患者中，76 例（71.7%）接受了新辅助化疗，30 例（28.3%）未接受。中位随访时间为 39.2 个月（范围为 12-286）。5 年和 10 年总生存率分别为 65.4%和 58.4%。肿瘤大小和组织学分级影响患者的总生存率（p<0.05）。在 2 级肿瘤患者中，肿瘤大小不影响预后。新辅助化疗改善了 3 级肿瘤患者的总生存率。
新辅助化疗治疗 3 级滑膜肉瘤高危患者有益，但对低危和 2 级肿瘤患者无效。肿瘤大小和组织学分级是患者预后的重要因素，但与病理模式无关。
