Author(s): Ferrari A, Gronchi A, Casanova M, Meazza C, Gandola L,
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Abstract BACKGROUND: The optimal treatment strategy for synovial sarcoma (SS) is subject to debate, and different strategies have been used for pediatric and adult patients. The current retrospective analysis examined a large group of patients of all ages who were treated at a single institution over a 30-year period. METHODS: The study included 271 patients who ranged in age from 5 years to 87 years; 255 had localized disease, which was macroscopically resected in 215 cases and deemed unresectable at diagnosis in 40 cases. Chemotherapy was administered to 41\% of patients, corresponding to 76\% of patients age or 16 years and < 20\% of older patients; 28\% of patients with macroscopically resected disease received chemotherapy on an adjuvant basis. RESULTS: The 5-year event-free survival rate for the study cohort as a whole was 37\%, although this rate varied with age (66\%, 40\%, and 31\% for patients age < or = 16 years, 17-30 years, and > 30 years, respectively). Chemotherapy was used more commonly for children than for adults. Among patients with surgically resected disease, the 5-year metastasis-free survival (MFS) rate was 60\% for those who were treated with chemotherapy and 48\% for those who were not; the benefit associated with chemotherapy use appeared to be greatest for patients age > or = 17 years who had tumors measuring > 5 cm (MFS, 47\% [chemotherapy] vs. 27\% [no chemotherapy]). In the subgroup of patients with measurable disease, the rate of tumor response to chemotherapy was approximately 48\%. CONCLUSIONS: Although the authors await more convincing proof of the efficacy of adjuvant chemotherapy in the treatment of adult soft tissue sarcoma, they recommend that patients with high-risk SS (tumor size > 5 cm) be the first to be considered for this type of treatment.
This article was published in Cancer
and referenced in Diagnostic Pathology: Open Access