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
3157 - Efficacy and safety of anlotinib in advanced leiomyosarcoma: Subgroup analysis of a phase IIB trial (ALTER0203)
Presenter: Yihebali Chi
Session: Poster Display session 1
Resources:
Abstract
3710 - The effect of treatment line on the efficacy of Anlotinib hydrochloride in advanced alveolar soft part sarcoma patients
Presenter: Zhiwei Fang
Session: Poster Display session 1
Resources:
Abstract
3184 - Prior exposure to pazopanib (PAZ) did not minor efficacy of regorafenib (REG) in non-adipocytic soft tissue sarcoma patients (pts)
Presenter: Nicolas Penel
Session: Poster Display session 1
Resources:
Abstract
798 - Pexidartinib (Pex) for locally advanced tenosynovial giant cell tumor (TGCT): characterization of hepatic adverse reactions (ARs)
Presenter: Sebastian Bauer
Session: Poster Display session 1
Resources:
Abstract
6117 - VEGFR2 and ITGA polymorphisms as novel pan-sarcoma biomarkers for sensitivity prediction as well as toxicity prevention anti-angiogenesis therapy in pediatric and young adult
Presenter: Qiyuan Bao
Session: Poster Display session 1
Resources:
Abstract
5450 - Reversion of resistance to mTOR inhibitors with the addition of exemestane in patients with malignant PEComa.
Presenter: Roberta Sanfilippo
Session: Poster Display session 1
Resources:
Abstract
4279 - Efficacy and Safety of VEGFR2 Inhibitor Apatinib combined with chemotherapy for Sarcoma in Stage IV
Presenter: Zhiwu Ren
Session: Poster Display session 1
Resources:
Abstract
5929 - Outcomes of metastatic soft tissue sarcoma treated with Pazopanib from dedicated medical oncology sarcoma clinic: A holistic care approach from a developing country
Presenter: Akhil Kapoor
Session: Poster Display session 1
Resources:
Abstract
2469 - Inhibition of mTOR signaling enhances Trabectedin activity in Soft Tissue Sarcoma
Presenter: David Moura
Session: Poster Display session 1
Resources:
Abstract
4210 - Efficacy and safety of apatinib for advanced gastrointestinal stromal tumors after failure of imatinib and sunitinib: An open-label, multicenter, single-arm, phase II trial
Presenter: Zhaolun Cai
Session: Poster Display session 1
Resources:
Abstract