Favorable outcomes of localized synovial sarcoma patients with a high utilization rate of neoadjuvant and/or adjuvant chemotherapy

Outani,Hidetatsu; Kakunaga,Shigeki; Hamada,Kenichiro; Takenaka,Satoshi; Imura,Yoshinori; Nagata,Shigenori; Tanaka,Takaaki; Tamiya,Hironari; Oshima,Kazuya; Naka,Norifumi; Kudawara,Ikuo; Araki,Nobuhito; Ueda,Takafumi; Yoshikawa,Hideki

doi:10.3892/mco.2019.1863

Favorable outcomes of localized synovial sarcoma patients with a high utilization rate of neoadjuvant and/or adjuvant chemotherapy

Authors:
- Hidetatsu Outani
- Shigeki Kakunaga
- Kenichiro Hamada
- Satoshi Takenaka
- Yoshinori Imura
- Shigenori Nagata
- Takaaki Tanaka
- Hironari Tamiya
- Kazuya Oshima
- Norifumi Naka
- Ikuo Kudawara
- Nobuhito Araki
- Takafumi Ueda
- Hideki Yoshikawa
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Affiliations: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, Suita, Osaka 565‑0871, Japan, Department of Orthopaedic Surgery, Osaka National Hospital, Chuo‑ku, Osaka 540‑0006, Japan, Musculoskeletal Oncology Service, Osaka International Cancer Institute, Chuo‑ku, Osaka 541‑8567, Japan, Department of Diagnostic Pathology and Cytology, Osaka International Cancer Institute, Chuo‑ku, Osaka 541‑8567, Japan, Department of Orthopaedic Surgery, Bell‑land General Hospital, Sakai, Osaka 599‑8247, Japan, Department of Orthopaedic Surgery, Ashiya Municipal Hospital, Ashiya, Hyogo 659‑8502, Japan
Published online on: May 21, 2019 https://doi.org/10.3892/mco.2019.1863
Pages: 151-156

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Abstract

Synovial sarcoma (SS) is considered to be a chemosensitive, soft tissue sarcoma. Therefore, neoadjuvant and/or adjuvant chemotherapy (N/AC) is used for the treatment of high‑risk SS patients. However, the role of N/AC remains controversial. The present study aimed to review the clinical outcomes of surgically treated localized SS and investigate the effects of N/AC with long‑term observation. The clinical outcomes of 54 patients with surgically treated localized SS were retrospectively analyzed. The median patient age was 42 years (range, 8‑81 years), and the median follow‑up period was 94 months for survivors (range, 7‑220 months). A total of 38 patients (70%) received chemotherapy. Of these, 32 (59%) patients received neoadjuvant chemotherapy, 33 (61%) received adjuvant chemotherapy, and 27 (50%) received neoadjuvant and adjuvant chemotherapy. Fourteen patients (26%) received adjuvant radiotherapy. Three patients (6%) had local recurrence and 13 patients (24%) developed distant metastasis. The overall survival (OS) rates at 5 and 10 years were 87 and 84%, respectively. N/AC did not improve survival. In conclusion, we found satisfactory long‑term OS among patients with a high utilization rate of N/AC. Further study should be necessary to evaluate which population of SS would benefit from N/AC.

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1	Ogura K, Higashi T and Kawai A: Statistics of soft-tissue sarcoma in Japan: Report from the bone and soft tissue tumor registry in Japan. J Orthop Sci. 22:755–764. 2017. View Article : Google Scholar : PubMed/NCBI
2	Pisters PW, O'Sullivan B and Maki RG: Evidence-based recommendations for local therapy for soft tissue sarcomas. J Clin Oncol. 25:1003–1008. 2007. View Article : Google Scholar : PubMed/NCBI
3	Vlenterie M, Litière S, Rizzo E, Marréaud S, Judson I, Gelderblom H, Le Cesne A, Wardelmann E, Messiou C, Gronchi A and van der Graaf WT: Outcome of chemotherapy in advanced synovial sarcoma patients: Review of 15 clinical trials from the European organisation for research and treatment of cancer soft tissue and bone sarcoma group; setting a new landmark for studies in this entity. Eur J Cancer. 58:62–72. 2016. View Article : Google Scholar : PubMed/NCBI
4	Palmerini E, Staals EL, Alberghini M, Zanella L, Ferrari C, Benassi MS, Picci P, Mercuri M, Bacci G and Ferrari S: Synovial sarcoma: Retrospective analysis of 250 patients treated at a single institution. Cancer. 115:2988–2998. 2009. View Article : Google Scholar : PubMed/NCBI
5	Ferrari A, Gronchi A, Casanova M, Meazza C, Gandola L, Collini P, Lozza L, Bertulli R, Olmi P and Casali PG: Synovial sarcoma: A retrospective analysis of 271 patients of all ages treated at a single institution. Cancer. 101:627–634. 2004. View Article : Google Scholar : PubMed/NCBI
6	Eilber FC, Brennan MF, Eilber FR, Eckardt JJ, Grobmyer SR, Riedel E, Forscher C, Maki RG and Singer S: Chemotherapy is associated with improved survival in adult patients with primary extremity synovial sarcoma. Ann Surg. 246:105–113. 2007. View Article : Google Scholar : PubMed/NCBI
7	Canter RJ, Qin LX, Maki RG, Brennan MF, Ladanyi M and Singer S: A synovial sarcoma-specific preoperative nomogram supports a survival benefit to ifosfamide-based chemotherapy and improves risk stratification for patients. Clin Cancer Res. 14:8191–8197. 2008. View Article : Google Scholar : PubMed/NCBI
8	Lewis JJ, Antonescu CR, Leung DH, Blumberg D, Healey JH, Woodruff JM and Brennan MF: Synovial sarcoma: A multivariate analysis of prognostic factors in 112 patients with primary localized tumors of the extremity. J Clin Oncol. 18:2087–2094. 2000. View Article : Google Scholar : PubMed/NCBI
9	Trassard M, Le Doussal V, Hacène K, Terrier P, Ranchère D, Guillou L, Fiche M, Collin F, Vilain MO, Bertrand G, et al: Prognostic factors in localized primary synovial sarcoma: A multicenter study of 128 adult patients. J Clin Oncol. 19:525–534. 2001. View Article : Google Scholar : PubMed/NCBI
10	Italiano A, Penel N, Robin YM, Bui B, Le Cesne A, Piperno-Neumann S, Tubiana-Hulin M, Bompas E, Chevreau C, Isambert N, et al: Neo/adjuvant chemotherapy does not improve outcome in resected primary synovial sarcoma: A study of the French sarcoma group. Ann Oncol. 20:425–430. 2009. View Article : Google Scholar : PubMed/NCBI
11	Amin M, Edge S, Greene F, Byrd DR, Brookland RK, Washington MK, Gershenwald JE, Compton CC, Hess KR, Sullivan DC, et al: AJCC Cancer Staging Manual (8th edition). (New York). Springer. 2017.
12	Trojani M, Contesso G, Coindre JM, Rouesse J, Bui NB, de Mascarel A, Goussot JF, David M, Bonichon F and Lagarde C: Soft-tissue sarcomas of adults; study of pathological prognostic variables and definition of a histopathological grading system. Int J Cancer. 33:37–42. 1984. View Article : Google Scholar : PubMed/NCBI
13	Krieg AH, Hefti F, Speth BM, Jundt G, Guillou L, Exner UG, von Hochstetter AR, Cserhati MD, Fuchs B, Mouhsine E, et al: Synovial sarcomas usually metastasize after >5 years: A multicenter retrospective analysis with minimum follow-up of 10 years for survivors. Ann Oncol. 22:458–467. 2011. View Article : Google Scholar : PubMed/NCBI
14	Bergh P, Meis-Kindblom JM, Gherlinzoni F, Berlin O, Bacchini P, Bertoni F, Gunterberg B and Kindblom LG: Synovial sarcoma: Identification of low and high risk groups. Cancer. 85:2596–2607. 1999. View Article : Google Scholar : PubMed/NCBI
15	Vlenterie M, Ho VK, Kaal SE, Vlenterie R, Haas R and van der Graaf WT: Age as an independent prognostic factor for survival of localised synovial sarcoma patients. Br J Cancer. 113:1602–1606. 2015. View Article : Google Scholar : PubMed/NCBI
16	Chen Y, Yang Y, Wang C and Shi Y: Adjuvant chemotherapy decreases and postpones distant metastasis in extremity stage IIB/III synovial sarcoma patients. J Surg Oncol. 106:162–168. 2012. View Article : Google Scholar : PubMed/NCBI
17	Vining CC, Sinnamon AJ, Ecker BL, Kelz RR, Fraker DL, Roses RE and Karakousis GC: Adjuvant chemotherapy in resectable synovial sarcoma. J Surg Oncol. 116:550–558. 2017. View Article : Google Scholar : PubMed/NCBI
18	Song S, Park J, Kim HJ, Kim IH, Han I, Kim HS and Kim S: Effects of adjuvant radiotherapy in patients with synovial sarcoma. Am J Clin Oncol. 40:306–311. 2017. View Article : Google Scholar : PubMed/NCBI
19	Naing KW, Monjazeb AM, Li CS, Lee LY, Yang A, Borys D and Canter RJ: Perioperative radiotherapy is associated with improved survival among patients with synovial sarcoma: A SEER analysis. J Surg Oncol. 111:158–164. 2015. View Article : Google Scholar : PubMed/NCBI