Abstract
BackgroundThis study aimed to explore the clinical efficacy of neoadjuvant chemotherapy combined with surgery in primary synovial sarcoma of the limbs and trunk through retrospective analysis of patients with primary synovial sarcoma of the limbs and trunk treated by this treatment in our hospital.MethodsA total of 89 patients diagnosed with synovial sarcoma were enrolled in this study between January 2005 and December 2011 in PLA General Hospital. Most of the patients received neoadjuvant chemotherapy combined with operative treatment (84.3%), 10.1% of them received adjuvant chemotherapy combined with operative treatment, and only 5.6% received merely operative treatment. The influence on the prognosis of patients with synovial sarcoma was analyzed by the statistics overall survival (OS), progression-free survival (PFS), local control (LC), and freedom from distant metastasis (FFDM).ResultsThe median follow-up time was 68.6 months. The 5-year OS, 5-year PFS, 5-year LC, and 5-year FFDM of the patients were 80.2, 60.5, 78.8, and 80.8%, respectively. The OS of the patients with a tumor size >5 cm was lower (91.4 vs 73.1%, P < 0.05). Besides, the OS and FFDM of neoadjuvant chemotherapy were better than those of adjuvant chemotherapy (84.5 vs 55.6%, P = 0.015, and 83.8 vs 55.6%, P = 0.028, respectively). However, there was no significant difference in the LC and PFS.ConclusionsNeoadjuvant chemotherapy was beneficial for patients with synovial sarcoma, and it could improve survival time and control distant metastasis. Tumor size was an important factor influencing patients’ prognosis.
Highlights
This study aimed to explore the clinical efficacy of neoadjuvant chemotherapy combined with surgery in primary synovial sarcoma of the limbs and trunk through retrospective analysis of patients with primary synovial sarcoma of the limbs and trunk treated by this treatment in our hospital
Synovial sarcoma is not tumor derived from synovial tissues, but it was named as such because it is frequently seen in soft tissues around the joints, which were mistaken to be derived from synovial tissues
Tumor staging was made according to the Enneking staging system and the American Joint Committee on Cancer (AJCC) 7th edition staging system
Summary
This study aimed to explore the clinical efficacy of neoadjuvant chemotherapy combined with surgery in primary synovial sarcoma of the limbs and trunk through retrospective analysis of patients with primary synovial sarcoma of the limbs and trunk treated by this treatment in our hospital. Synovial sarcoma is a high-grade soft tissue sarcoma with poor prognosis and accounts for 5~10% of soft tissue sarcomas [1]. It commonly occurs in young people; the age of onset is usually 15 to 40 years old. It has been proved that synovial sarcoma could occur in multiple sites and organs. The origin of synovial sarcoma is not very clear, and nervous tissue, muscular tissue, and mesenchymal stem cells are likely to be its source [2]. Synovial sarcoma is divided into unipolar type, bipolar type, and undifferentiated type. It possesses a constant chromosome translocation, commonly
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