Department of Orthopaedic Surgery, Mie Graduate School of Medicine Tsu, Japan.
Department of Pediatrics, Tama-Hokubu Medical Center Higashimurayama, Japan.
Jpn J Clin Oncol. 2021 May 28;51(6):927-931. doi: 10.1093/jjco/hyab039.
Synovial sarcoma is the most common soft tissue sarcomas among childhood and adolescents, accounting for 8-10% of all soft tissue sarcoma. Synovial sarcoma is considered a relatively chemosensitive tumor compared with other soft tissue sarcomas. However, the role of perioperative chemotherapy in synovial sarcoma remains controversial. The purpose of this systematic review is to evaluate the role of perioperative chemotherapy in childhood and adolescent patients with synovial sarcoma.
We evaluated studies published between 1 January 1990 and 31 December 2017. The following databases were searched: MEDLINE, Cochrane database (via PubMed) and Ichushi (in Japanese).
The search yielded 216 articles in English and Japanese. After the initial screening, based on the title and abstract, 160 articles were excluded. As a second screening, we then assessed the full text of the remaining 56 articles for eligibility. Finally, 10 articles were included in the systematic review. Surgical resection with R0 margin alone was recommended because of the excellent results of two prospective studies. Meta-analysis was performed using data from two retrospective studies of 261 patients. Perioperative chemotherapy did not have a significant effect on survival and event-free survival.
We weakly do not recommend perioperative chemotherapy in patients with non-metastatic synovial sarcoma ≤ 5 cm when R0 resection is acquired. There was no consensus concerning the role of perioperative chemotherapy in patients with synovial sarcoma > 5 cm or those with ≤5 cm who undergo R1 or R2 resection.
滑膜肉瘤是儿童和青少年中最常见的软组织肉瘤，占所有软组织肉瘤的 8-10%。与其他软组织肉瘤相比，滑膜肉瘤被认为是一种相对敏感的肿瘤。然而，围手术期化疗在滑膜肉瘤中的作用仍存在争议。本系统评价的目的是评估围手术期化疗在儿童和青少年滑膜肉瘤患者中的作用。
我们评估了 1990 年 1 月 1 日至 2017 年 12 月 31 日期间发表的研究。检索了以下数据库：MEDLINE、Cochrane 数据库（通过 PubMed）和 Ichushi（日文）。
搜索结果在英文和日文中共产生了 216 篇文章。经过初步筛选，根据标题和摘要，排除了 160 篇文章。作为第二轮筛选，我们评估了其余 56 篇文章的全文以确定其是否符合纳入标准。最终，有 10 篇文章被纳入系统评价。由于两项前瞻性研究的出色结果，建议单独进行 R0 边界的手术切除。对来自两项回顾性研究（共 261 例患者）的数据进行了荟萃分析。围手术期化疗对生存和无事件生存没有显著影响。
当获得 R0 切除时，我们不强烈建议对非转移性滑膜肉瘤≤5cm 的患者进行围手术期化疗。对于滑膜肉瘤>5cm 或接受 R1 或 R2 切除的≤5cm 的患者，围手术期化疗的作用尚无共识。
