Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha, 410011, Hunan, China.
Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha, 410011, Hunan, China.
Int Orthop. 2020 Dec;44(12):2779-2786. doi: 10.1007/s00264-020-04708-5. Epub 2020 Sep 3.
By comparing epidemiologic and prognostic data of synovial sarcoma subtypes, this study aims to clarify the difference in prognosis and risk factors among different synovial sarcoma subtypes.
In total, 1692 patients with synovial sarcoma in the USA who were diagnosed during 1975 through 2016 and retrieved from the Surveillance, Epidemiology, and End Results (SEER) program were studied.
There were statistically significant differences in the distribution of age and race among three synovial sarcoma subtypes, while no major differences in the distribution of sex, tumor stage, and tumour size were found. The highest five and ten year survival rates were found in the biphasic subtype (69%, 60%), followed by the monophasic subtype (59%, 49%), and lowest in the epithelioid subtype (32%, 26%). Age and SEER historic stage were the two demographic factors that found to have statistically significant impact on survival in all subtypes. Radiation was found to be protective in the monophasic subtype (HR 0.61, p < 0.001).
Among different synovial sarcoma subtypes, the biphasic subtype favoured the best survival, while the epithelioid cell subtype was associated with the worst. Male and black race were independently associated with worse survival only in the monophasic subtype. Radiotherapy could provide significant benefit for patients with the monophasic synovial sarcoma.
通过比较滑膜肉瘤亚型的流行病学和预后数据，本研究旨在阐明不同滑膜肉瘤亚型之间预后和危险因素的差异。
本研究共纳入了 1975 年至 2016 年期间在美国被诊断为滑膜肉瘤且来自监测、流行病学和最终结果（SEER）项目的 1692 名患者。
三种滑膜肉瘤亚型在年龄和种族分布上存在统计学差异，而在性别、肿瘤分期和肿瘤大小分布上无明显差异。双相型的五年和十年生存率最高（分别为 69%和 60%），单相型次之（分别为 59%和 49%），上皮样型最低（分别为 32%和 26%）。年龄和 SEER 历史分期是所有亚型中发现对生存有统计学显著影响的两个人口统计学因素。在单相型中，放疗被发现具有保护作用（HR 0.61，p<0.001）。
在不同的滑膜肉瘤亚型中，双相型的生存情况最好，而上皮样细胞型的生存情况最差。男性和黑人种族仅在单相型中与较差的生存独立相关。放疗可为单相滑膜肉瘤患者提供显著获益。
