Clinical and pathological features of patients with resected synovial sarcoma: A multicenter retrospective analysis of the Anatolian Society of Medical Oncology
Yetisyigit Tarkan1, Arpaci Erkan2, Erdogan Seber Selcuk3, Kucukoner Mehmet4, Kos F Tugba5, Uysal Sonmez Ozlem2, Alici Suleyman6, Akman Tulay7, Aktas Bilge3, Yildiz Ramazan8, Gunaydin Yusuf9, Inanc Mevlude10, Demirci Umut8, Oztop Ilhan6, Isikdogan Abdurrahman4, Sevinc Alper11, Uncu Dogan5, Alkis Necati2, Oksuzoglu Berna2, Durnali Ayse Gok2, Yilmaz Ugur6, Gumus Mahmut7
1 Department of Medical Oncology, Namik Kemal University, Tekirdag, Turkey
2 Department of Medical Oncology, Dr. Abdurrahman Yurtaslan Education and Research Hospital, Ankara, Turkey
3 Department of Medical Oncology, Marmara University, Istanbul, Turkey
4 Department of Medical Oncology, Dicle University, Diyarbakir, Turkey
5 Department of Medical Oncology, Ankara Numune Education and Research Hospital, Ankara, Turkey
6 Department of Medical Oncology, Göztepe Medical Park Hospital, Istanbul, Turkey
7 Department of Medical Oncology, Dokuz Eylul University, Izmir, Turkey
8 Department of Medical Oncology, Kartal Education and Research Hospital, Istanbul, Turkey
9 Department of Medical Oncology, Gazi University, Ankara, Turkey
10 Department of Medical Oncology, Erciyes University, Kayseri, Turkey
11 Department of Medical Oncology, Gaziantep University, Gaziantep, Turkey
Department of Medical Oncology, Namik Kemal University Hospital, 100 Yil Mah, Tunca Cad, Merkez, Tekirdag 59100
Source of Support: None, Conflict of Interest: None
Background: Synovial sarcoma (SS) is a rare disease and compared with other soft-tissue sarcomas has a relatively high mortality rate. The optimal management of this disease and prognostic factors associated with patient outcome remains controversial.
Aims: We aimed to evaluate the factors affecting the outcomes of SS patients in the adjuvant setting.
Patients and Methods: In this Turkish multicenter study, we assessed the data of 69 SS patients regarding prognostic factors for SS patients retrospectively.
Results: Our study included 69 localized SS patients (38 males and 31 females) with a median age of 34.5 years (minimum-maximum: 14-68 years). Overall survival (OS) and disease free survival (DFS) rates for 5 years were 64% and 25%, respectively. All patients under went surgical treatment; 64 patients were treated with a wide excision and 5 patients had an amputation. According to the univariate analysis, adverse prognostic factors for OS were male sex, higher mitotic activity, high Ki-67 levels, trunk localization and inadequate surgical margins. In multivariate analysis, none of these factors had independent significant association with OS. Prognostic factors for DFS; in the univariate analysis were higher mitotic activity, high Ki-67 levels and inadequate surgical margins. Only higher mitotic activity (≥10 high-power field) was significantly associated with worse DFS in the multivariate analysis (hazard ratio: 0.30, % confidence interval: 0.11-0.80, P = 0.017).
Conclusion: Our study confirms that high mitotic activity is significantly associated with decreased DFS. The question of whether the chemotherapy provides a survival advantage in patients having adverse prognostic factors requires confirmation in randomized trials.
Abstract in Chinese