Abstract 3141
Background
Synovial sarcoma is a high-grade, malignant soft tissue sarcoma (STS) considered as relatively chemosensitive tumor, with particular sensitivity to ifosfamide. The aim of this prospective study was to analyze outcomes of patients (pts) with localized synovial sarcoma treated in a single institution with uniform neo- and adjuvant combined therapy protocol.
Methods
One hundred and seventy one pts (96 women and 75 men) with localized synovial sarcoma were treated at our institution between 1997 and 2014. Chemotherapy consisted of 4 cycles of ifosfamide 12 g/m2 (2 cycles given preoperatively) and two cycles of doxorubicin-based regimen 75 mg/m2. Most pts received neoadjuvant hypofractionated radiation therapy followed by immediate surgery. At a median follow-up of 114 months (range, 3 to 244 months) 69 deaths were recorded.
Results
Median age at diagnosis was 33 years (range 17-69). The most common localization was lower limb (n = 121), followed by upper limb (n = 32). Tumors larger than 5 cm in size were found in 70% of pts (median 8 cm; range 2 – 30 cm). Seventy-seven cases (45%) had primary diagnosed tumor. Sixty-four (37%) pts were referred to our institute after unplanned tumor excision and 30 (18%) pts because of clinical local recurrence. At the time of analysis, 36 (21%) pts had local recurrence (only 8% of pts with primary tumor) and 76 (44%) pts developed metastases. Median disease-free survival was 82 months. The 5-year overall survival (OS), local recurrence-free survival (LRFS) and distant recurrence-free survival (DRFS) rates were 74%, 80% and 60%, respectively. By univariate analysis, unplanned tumor excision (p = 0.0025) and positive margins (p = 0.048) were related to higher risk of local recurrence. In multivariable Cox’s regression, age >35 years (p = 0.045), male sex (p = 0.001), stage IIIB (p < 0.01) and histology other than monophasic (p = 0.033) were associated with worse OS.
Conclusions
In adult patients with localized synovial sarcoma, a long-term survival and local control can be achieved with intensive combined therapy. Our results confirms the importance of planned surgery and clear surgical margins for local control. We have demonstrated that age, sex, disease stage, and histology are independent prognostic factors of overall survival.
Clinical trial identification
Editorial acknowledgement
Legal entity responsible for the study
Maria Sklodowska-Curie Institute - Oncology Center, Warsaw, Poland.
Funding
Has not received any funding.
Disclosure
H.M. Kosela Paterczyk: Honoraria (institution): Novartis; Honoraria (self): MSD; Honoraria (self): BMS. P. Rutkowski: Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: MSD; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony: Novartis; Honoraria (self), Advisory / Consultancy, Speaker Bureau / Expert testimony, Research grant / Funding (institution): BMS; Honoraria (self): Roche; Honoraria (self), Speaker Bureau / Expert testimony: Pfizer; Honoraria (self), Speaker Bureau / Expert testimony: Eli Lilly; Advisory / Consultancy: Blueprint Medicines. All other authors have declared no conflicts of interest.
Resources from the same session
4369 - Biomarker testing of lung cancer in Spain
Presenter: Delvys Rodriguez Abreu
Session: Poster Display session 1
Resources:
Abstract
603 - Mendelian Randomization Study of Alzheimer's Disease and Lung Cancer
Presenter: Huaqiang Zhou
Session: Poster Display session 1
Resources:
Abstract
4462 - Spanish registry of thoracic tumors (TTR): Interim analyses of comorbidities, risk associations, personal and family history of cancer
Presenter: Rafael Lopez Castro
Session: Poster Display session 1
Resources:
Abstract
3957 - Pleural effusion TGF-beta is highly diagnostic and prognostic in malignant pleural mesothelioma
Presenter: Paul Stockhammer
Session: Poster Display session 1
Resources:
Abstract
3583 - Immune microenvironment modulation by p14/ARF in Malignant Pleural Mesothelioma
Presenter: Giulia Pasello
Session: Poster Display session 1
Resources:
Abstract
4255 - Tumor Treating Fields plus chemotherapy for first-line malignant pleural mesothelioma (MPM): radiological responses in the STELLAR trial
Presenter: Federica Grosso
Session: Poster Display session 1
Resources:
Abstract
1803 - Effects of Tumor Treating Fields (TTFields; 150 kHz) and Cisplatin or Pemetrexed Combination Therapy on Mesothelioma cells In Vitro and In Vivo
Presenter: Mijal Munster
Session: Poster Display session 1
Resources:
Abstract
2660 - Real world use of systemic therapy in elderly patients with malignant pleural mesothelioma (MPM)
Presenter: Susana Cedres
Session: Poster Display session 1
Resources:
Abstract
3150 - Pemetrexed/Cisplatin versus Gemcitabine/Cisplatin as first-line treatment for Egyptian patients with malignant pleural mesothelioma
Presenter: Mohamed Alorabi
Session: Poster Display session 1
Resources:
Abstract
4319 - Accuracy of pathologic evaluation for thymic epithelial tumors in an Italian reference Centre
Presenter: Giulia Galli
Session: Poster Display session 1
Resources:
Abstract