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
2023 - Patients with brain metastases treated with afatinib in clinical practice – results from the prospective non-interventional study GIDEON
Presenter: Eckart Laack
Session: Poster Display session 1
Resources:
Abstract
1613 - Lerociclib (G1T38), an oral CDK4/6 inhibitor, dosed continuously in combination with osimertinib for EGFRmut non-small cell lung cancer: initial Phase 1b results
Presenter: David Berz
Session: Poster Display session 1
Resources:
Abstract
2853 - Real-world implementation of sequential targeted therapies for EGFR-mutated NSCLC
Presenter: Petros Christopoulos
Session: Poster Display session 1
Resources:
Abstract
1974 - A Phase II Open-Label, Multicentre Study to Assess the Anti-tumour Activity of Afatinib in Patients with Activating Epidermal Growth Factor Receptor mutation (EGFRm) from Circulating Tumor DNA (CtDNA)
Presenter: Young-Chul Kim
Session: Poster Display session 1
Resources:
Abstract
3370 - Influence of cow’s milk on the absorption and exposure of erlotinib in NSCLC patients
Presenter: Geerten Veerman
Session: Poster Display session 1
Resources:
Abstract
5900 - PTEN loss as Predictor of Tumor Heterogeneity (TH) and Poor Prognosis in EGFR-mutant Advanced Non-Small Cell Lung Cancer (ANSCLC) Patients (pts) Receiving Tyrosine-Kinase Inhibitors (TKIs).
Presenter: Miriam Ferrara
Session: Poster Display session 1
Resources:
Abstract
1302 - Safety of lorlatinib in subgroups of patients from a phase 1/2 trial
Presenter: Enriqueta Felip
Session: Poster Display session 1
Resources:
Abstract
1497 - Brigatinib (BRG) in Asian vs non-Asian patients (pts) with crizotinib (CRZ)-refractory ALK+ NSCLC in the phase 2 ALTA trial
Presenter: Dae Ho Lee
Session: Poster Display session 1
Resources:
Abstract
2349 - The safety assessment of crizotinib and alectinib from real world data of 840 ALK-inhibitor naïve patients with NSCLC harboring ALK-rearrangement (WJOG9516L).
Presenter: Kei Kunimasa
Session: Poster Display session 1
Resources:
Abstract
1120 - Brigatinib in ALK TKI-pretreated ALK+ metastatic non-small cell lung cancer (mNSCLC): the Use Via Expanded Access to Brigatinib (UVEA-Brig) study
Presenter: Silvia Novello
Session: Poster Display session 1
Resources:
Abstract