Clinical and pathological features of patients with resected synovial sarcoma: a multicenter retrospective analysis of the Anatolian Society of Medical Oncology.

Abstract

Synovial sarcoma (SS) is a rare disease and compared with other soft-tissue sarcomas has a relatively high mortality rate. The optimal management of this disease and prognostic factors associated with patient outcome remains controversial. We aimed to evaluate the factors affecting the outcomes of SS patients in the adjuvant setting. In this Turkish multicenter study, we assessed the data of 69 SS patients regarding prognostic factors for SS patients retrospectively. Our study included 69 localized SS patients (38 males and 31 females) with a median age of 34.5 years (minimum-maximum: 14-68 years). Overall survival (OS) and disease free survival (DFS) rates for 5 years were 64% and 25%, respectively. All patients under went surgical treatment; 64 patients were treated with a wide excision and 5 patients had an amputation. According to the univariate analysis, adverse prognostic factors for OS were male sex, higher mitotic activity, high Ki-67 levels, trunk localization and inadequate surgical margins. In multivariate analysis, none of these factors had independent significant association with OS. Prognostic factors for DFS; in the univariate analysis were higher mitotic activity, high Ki-67 levels and inadequate surgical margins. Only higher mitotic activity (≥10 high-power field) was significantly associated with worse DFS in the multivariate analysis (hazard ratio: 0.30, % confidence interval: 0.11-0.80, P = 0.017). Our study confirms that high mitotic activity is significantly associated with decreased DFS. The question of whether the chemotherapy provides a survival advantage in patients having adverse prognostic factors requires confirmation in randomized trials.