Oncological outcome of extremity synovial sarcomas treated with multimodality management

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Soft Tissue Sarcomas
Therapy
Presenter ASHISH Gulia
Citation Annals of Oncology (2018) 29 (suppl_9): ix124-ix128. 10.1093/annonc/mdy443
Authors A. Gulia1, A. Puri1, S. Laskar2, B. Rekhi3
  • 1Surgical Oncology, Tata Memorial Centre, 400012 - Mumbai/IN
  • 2Radiation Oncology, Tata Memorial Centre, 400012 - Mumbai/IN
  • 3Pathology, Tata Memorial Centre, 400012 - Mumbai/IN

Abstract

Background

To determine the outcome of extremity synovial sarcomas treated at our centre.

Methods

This is a retrospective review of a prospectively maintained database. Two hundred and forty eight patients of extremity synovial sarcoma operated at our institution between January 2006 and December 2015 were included in the study. Clinico pathological characteristics, treatment given and oncological outcome were analysed. Localised disease was seen in 210 (85%) patients and 38 (15%) had metastatic disease at presentation. Amputation was done in 60 patients (24%) while limb salvage surgery was possible in 188 cases (76%). Radiation therapy in either preoperative or postoperative settings was given to 168 patients (68%) and 159 (64%) patients received chemotherapy.

Results

Median duration of follow up was 31 month (2 – 130 months) while for survivors it is 45 months (2-130 months). At time of last follow up 153 patients were alive, 82 were dead and 13 patients were lost to follow up. Overall, 11 patients developed only local recurrence (LR), 97 developed only distant recurrence (DR) and 28 had both LR and DR. Of 13 patients who had margin positive, 7 had only DR and one each had LR and LR with DR, one patient was lost to follow up and 3 patients were disease free. The 3-year overall survival rate 74% for the entire cohort. The 3-year disease - free survival rate of localised synovial sarcoma was 56.6%. On multivariate analysis- size, type of surgery performed and use of radiation therapy is associated with disease free survival.

Conclusions

Synovial sarcoma is a rare disease, which requires multi modality management for better outcomes. Limb sparing surgery is possible in majority of patients. Risk of metastatic disease is high inspite of wide resection and use of radiation therapy and chemotherapy.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Ethics review Committee of Tata Memorial Centre.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.