The Long-Term Outcomes of Intensive Combined Therapy of Adult Patients with Localised Synovial Sarcoma

• Main Authors: Katarzyna Kozak, Paweł Teterycz, Tomasz Świtaj, Hanna Koseła-Paterczyk, Sławomir Falkowski, Tadeusz Morysiński, Ewa Bartnik, Anna M. Czarnecka, Michał Wągrodzki, Iwona Ługowska, Piotr Rutkowski
• Format: Article
• Language: English
• Published: MDPI AG 2020-09-01
• Series: Journal of Clinical Medicine
• Subjects: synovial sarcoma; neoadjuvant; adjuvant; chemotherapy; radiotherapy; prognostic factors
• Online Access: https://www.mdpi.com/2077-0383/9/10/3129

Introduction: Synovial sarcoma (SaSy) is a high-grade, malignant soft tissue sarcoma (STS) accounting for 5–9% of STS. The aim of this study was to analyse outcomes of patients with localised SaSy treated in a single institution with a uniform neo- and adjuvant-combined therapy protocol. Methods: 171 patients with stage II/III SaSy were treated between 1997 and 2014. Chemotherapy consisted of 4 cycles of ifosfamide 12 g/m² and two cycles of a doxorubicin-based regimen 75 mg/m². With the exception of patients who underwent amputation, all patients received neoadjuvant radiotherapy. Results: Median age was 33 years (range 17–69). Tumours larger than 5 cm in size were found in 70% of patients. The 5-year overall survival (OS), local relapse-free survival (LRFS) and metastasis-free survival (MFS) rates were 75%, 80% and 60%, respectively. In multivariate Cox’s regression, age > 35 years, male sex, larger tumour size and histology other than monophasic were associated with worse OS. Conclusions: In adult patients with localised SaSy, long-term survival can be achieved in a significant proportion of cases with intensive combined therapy. The multivariate analysis identified age, sex, disease stage and histology subtype as independent prognostic factors of OS.