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Year : 2014  |  Volume : 10  |  Issue : 1  |  Page : 73-78

Clinical and pathological features of patients with resected synovial sarcoma: A multicenter retrospective analysis of the Anatolian Society of Medical Oncology

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

Correspondence Address:
Yetisyigit Tarkan
Department of Medical Oncology, Namik Kemal University Hospital, 100 Yil Mah, Tunca Cad, Merkez, Tekirdag 59100
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Source of Support: None, Conflict of Interest: None

DOI: 10.4103/0973-1482.131381

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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

滑膜肉瘤病人术后的临床和病理特征:安纳托利亚医学肿瘤学协会的多中心回顾性分析 背景:滑膜肉瘤(SS)相对其它软组织肉瘤是一种罕见的疾病,并有相对高的致死率。关于此类病最佳治疗方案和预后因素尚存争议。 目的:我们旨在评估在辅助治疗中影响滑膜肉瘤病人转归的因素。 病人和方法:在这个土耳其多中心研究中,我们回顾性地分析了69例SS病人预后相关的数据。 结果:研究包括69例局限性SS病人(38男,31女),平均年龄34.5岁(最小14岁,最大68岁)。5年的总生存率(OS)和无病生存率(DFS)分别为64%和25%。所有病人接受了手术治疗;64例广泛切除,5例截肢。根据单变量分析,对OS不利的预后因素有:男性,高核分裂能力,高Ki-67水平,病灶靠近躯干,以及手术范围不足。多变量分析中,上述因素没有一项对OS有独立的显著关联。DFS的预后因素:单变量分析有高核分裂能力,高Ki-67水平,以及手术范围不足。多变量分析中,仅高核分裂能力(≥10 高功率场)与DFS差有显著相关(危险率:0.30,95%置信区间:0.11~0.80,P=0.017)。 结论:研究确定高核分裂能力与DFS的降低有明显相关。关于化疗是否对预后不良病人有益还需进一步随机试验确定。 关键词:Ki-67,核分裂能力,滑膜肉瘤

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