The Long-Term Outcomes of Intensive Combined Therapy of Adult Patients with Localised Synovial Sarcoma
Abstract
1. Introduction
2. Materials and Methods
Statistical Analysis
3. Results
3.1. Patients and Treatment
3.2. Local and Distant Recurrence
3.3. Disease-Free Survival
3.4. Overall Survival
3.5. Safety
4. Discussion
5. Conclusions
Author Contributions
Funding
Conflicts of Interest
References
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Characteristic | n | % |
---|---|---|
Age | ||
≤35 | 102 | 60 |
>35 | 69 | 40 |
Sex | ||
Female | 96 | 56 |
Male | 75 | 44 |
Histological subtype a | ||
Monophasic | 78 | 59 |
Biphasic | 44 | 33 |
Poorly differentiated | 11 | 8 |
Localisation of primary tumour | ||
Upper limb | 32 | 19 |
Lower limb | 121 | 71 |
Trunk wall | 15 | 9 |
Retroperitoneal space and head and neck | 3 | 2 |
Size of primary tumour, cm b | ||
≤5 | 35 | 30 |
>5 | 83 | 70 |
Disease stage according to AJCC b | ||
II | 35 | 30 |
IIIA | 55 | 47 |
IIIB | 28 | 24 |
Status at initiation of treatment in MSCNRIO | ||
Patients previously untreated (primary tumour) | 77 | 45 |
Patients after surgical treatment without prior diagnostic biopsy | 64 | 37 |
Clinical local recurrence | 30 | 18 |
Type of surgical treatment for localisation in an extremity | ||
Limb-sparing surgery | 136 | 89 |
Amputation | 17 | 11 |
Surgical margins | ||
R0 | 149 | 87 |
R1 | 22 | 13 |
Preoperative radiotherapy | 154 | |
5 × 4 Gy | 84 | 55 |
5 × 5 Gy | 69 | 45 |
28 × 1.8 Gy | 1 | 1 |
Number of cycles of perioperative adjuvant chemotherapy | ||
six | 149 | 87 |
five | 6 | 4 |
four | 7 | 4 |
three | 6 | 4 |
two | 3 | 2 |
Variable | 5-Year LRFS | 95% CI | p | 5-Year MFS | 95% CI | p | 5-Year OS | 95% CI | p |
---|---|---|---|---|---|---|---|---|---|
Age | |||||||||
≤35 | 80% | 0.72–0.89 | 0.82 | 66% | 0.58–0.76 | 0.0051 | 81% | 0.73–0.88 | 0.014 |
>35 | 81% | 0.70–0.93 | 52% | 0.41–0.66 | 67% | 0.57–0.80 | |||
Sex | |||||||||
Female | 88% | 0.81–0.95 | 0.02 | 70% | 0.62–0.81 | 0.0068 | 84% | 0.76–0.92 | <0.001 |
Male | 70% | 0.59–0.83 | 48% | 0.37–0.61 | 64% | 0.54–0.76 | |||
Histological subtype | |||||||||
Monophasic | 78% | 0.69–0.89 | 0.39 | 74% | 0.64–0.49 | 0.08 | 79% | 0.71–0.89 | 0.2 |
Biphasic | 84% | 0.73–0.96 | 44% | 0.32–0.62 | 60% | 0.47–0.77 | |||
Poorly differentiated | 100% | 1.00–1.00 | 50% | 0.27–0.92 | 54% | 0.26–1.00 | |||
Not specified | 76% | 0.63–0.93 | 58% | 0.44–0.76 | 65% | 0.51–0.82 | |||
T stage | |||||||||
T1 | 84% | 0.71–0.98 | 0.97 | 85% | 0.74–0.98 | <0.001 | 88% | 0.77–0.99 | 0.0039 |
T2 | 88% | 0.79–0.98 | 53% | 0.41–0.69 | 62% | 0.50–0.77 | |||
T3 | 85% | 0.71–1.00 | 32% | 0.17–0.61 | 51% | 0.33–0.78 | |||
T4 | 86% | 0.63–1.00 | 29% | 0.09–0.92 | 43% | 0.18–1.00 | |||
TNM stage | |||||||||
II | 84% | 0.71–0.98 | 0.86 | 85% | 0.74–0.98 | <0.001 | 88% | 0.77–0.99 | <0.001 |
IIIA | 88% | 0.79–0.98 | 53% | 0.41–0.69 | 62% | 0.50–0.77 | |||
IIIB | 85% | 0.72–1.00 | 28% | 0.15–0.52 | 47% | 0.31–0.71 | |||
Surgical margins | |||||||||
R0 | 82% | 0.76–0.89 | 0.048 | 62% | 0.55–0.71 | 0.57 | 73% | 0.66–0.81 | 0.25 |
R1 | 69% | 0.51–0.93 | 50% | 0.33–0.76 | 53% | 0.35–0.80 |
Variables | MFS HR (95% CI), p | DFS HR (95% CI), p | OS HR (95% CI), p |
---|---|---|---|
Male sex | 1.53 (0.90–2.60), p = 0.117 | 1.60 (0.97–2.64), p = 0.067 | 2.18 (1.25–3.78), p = 0.006 |
Age > 35 years | 2.53 (1.48–4.34), p = 0.001 | 2.39 (1.44–3.96), p = 0.001 | 2.03 (1.17–3.52), p = 0.012 |
Histologic subtype other than monophasic | 1.95 (1.11–3.44), p = 0.021 | 1.97 (1.15–3.35), p = 0.013 | 1.94 (1.09–3.44), p = 0.025 |
Tumour size (continuous variable) | 1.10 (1.05–1.16), p < 0.001 | 1.09 (1.04–1.14), p < 0.001 | 1.09 (1.04–1.14), p < 0.001 |
Study | Number of Patients | Size of Primary Tumour (%) | Median Follow-Up Time (Months) | R1 Resection (%) | RT Periop (%) | CHT (%) | 5-Year LRFs (%) | 5-Year MFS (%) | 5-Year OS (%) |
---|---|---|---|---|---|---|---|---|---|
Canter et al. (2008) [18] | 255 | ≥5 cm | 72 | - | 63 | 39 | - | 55 | 72 |
56 | |||||||||
Chen et al. (2012) [17] | 76 | ≥5 cm | 68 | 32 | 75 | 68 | - | 48 | 59 |
100 | |||||||||
Italiano et al. (2009) [3] | 237 | - | 58 | 15 | 76 | 60 | 70 | 57 | 64 |
Lewis et al. (2000) [5] | 112 | ≥5 cm | 72 | 14 | 46 | 37 | 78 | 61 | 75 |
45 | |||||||||
Palmerini et al. (2009) [2] | 204 | >5 cm | 66 | 12 | 52 | 52 | 81 | - | 76 |
49 | |||||||||
Trassard et al. (2001) [7] | 128 | ≥5 cm | 37 | 24 | 80 | 57 | - | - | 63 |
70 | |||||||||
This study (2020) | 171 | ≥5 cm | 114 | 13 | 90 | 100 | 80 | 60 | 75 |
73 | |||||||||
Ferrari et al. * (2004) [11] | 215 | >5 cm | 65 | - | 50 | 28 | 63 | 51 | 71 |
64 | |||||||||
Outani et al. * (2019) [15] | 191 | ≥5 cm | 68 | 7 | 55 | 30 | 89 | 66 | 76 |
63 |
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Kozak, K.; Teterycz, P.; Świtaj, T.; Koseła-Paterczyk, H.; Falkowski, S.; Morysiński, T.; Bartnik, E.; Czarnecka, A.M.; Wągrodzki, M.; Ługowska, I.; et al. The Long-Term Outcomes of Intensive Combined Therapy of Adult Patients with Localised Synovial Sarcoma. J. Clin. Med. 2020, 9, 3129. https://doi.org/10.3390/jcm9103129
Kozak K, Teterycz P, Świtaj T, Koseła-Paterczyk H, Falkowski S, Morysiński T, Bartnik E, Czarnecka AM, Wągrodzki M, Ługowska I, et al. The Long-Term Outcomes of Intensive Combined Therapy of Adult Patients with Localised Synovial Sarcoma. Journal of Clinical Medicine. 2020; 9(10):3129. https://doi.org/10.3390/jcm9103129
Chicago/Turabian StyleKozak, Katarzyna, Paweł Teterycz, Tomasz Świtaj, Hanna Koseła-Paterczyk, Sławomir Falkowski, Tadeusz Morysiński, Ewa Bartnik, Anna M. Czarnecka, Michał Wągrodzki, Iwona Ługowska, and et al. 2020. "The Long-Term Outcomes of Intensive Combined Therapy of Adult Patients with Localised Synovial Sarcoma" Journal of Clinical Medicine 9, no. 10: 3129. https://doi.org/10.3390/jcm9103129
APA StyleKozak, K., Teterycz, P., Świtaj, T., Koseła-Paterczyk, H., Falkowski, S., Morysiński, T., Bartnik, E., Czarnecka, A. M., Wągrodzki, M., Ługowska, I., & Rutkowski, P. (2020). The Long-Term Outcomes of Intensive Combined Therapy of Adult Patients with Localised Synovial Sarcoma. Journal of Clinical Medicine, 9(10), 3129. https://doi.org/10.3390/jcm9103129