1
|
Zhao Z, Niu J, Wang J, Zhang R, Liang H, Ma Y, Ferrena A, Wang W, Yang R, Geller DS, Guo W, Ren T, Hoang BH, Tang X, Yan T. Novel candidate metastasis-associated genes for synovial sarcoma. J Cell Mol Med 2024; 28:e18541. [PMID: 39046429 PMCID: PMC11267982 DOI: 10.1111/jcmm.18541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2023] [Revised: 07/01/2024] [Accepted: 07/11/2024] [Indexed: 07/25/2024] Open
Abstract
Synovial sarcoma (SS) is an aggressive soft tissue sarcoma with poor prognosis due to late recurrence and metastasis. Metastasis is an important prognostic factor of SS. This study aimed to identify the core genes and mechanisms associated with SS metastasis. Microarray data for GSE40021 and GSE40018 were obtained from the Gene Expression Omnibus database. 186 differentially expressed genes (DEGs) were identified. The biological functions and signalling pathways closely associated with SS metastasis included extracellular matrix (ECM) organization and ECM-receptor interaction. Gene set enrichment analysis showed that the terms cell cycle, DNA replication, homologous recombination and mismatch repair were significantly enriched in the metastasis group. Weighted gene co-expression network analysis identified the most relevant module and 133 hub genes, and 31 crossover genes were identified by combining DEGs. Subsequently, four characteristic genes, EXO1, NCAPG, POLQ and UHRF1, were identified as potential biomarkers associated with SS metastasis using the least absolute shrinkage and selection operator algorithm and validation dataset verification analysis. Immunohistochemistry results from our cohort of 49 patients revealed visible differences in the expression of characteristic genes between the non-metastatic and metastatic groups. Survival analysis indicated that high expression of characteristic genes predicted poor prognosis. Our data revealed that primary SS samples from patients who developed metastasis showed activated homologous recombination and mismatch repair compared to samples from patients without metastasis. Furthermore, EXO1, NCAPG, POLQ and UHRF1 were identified as potential candidate metastasis-associated genes. This study provides further research insights and helps explore the mechanisms of SS metastasis.
Collapse
Affiliation(s)
- Zhiqing Zhao
- Department of OrthopedicsPeking University First HospitalBeijingChina
| | - Jianfang Niu
- Department of OrthopedicsPeking University First HospitalBeijingChina
| | - Jichuan Wang
- Musculoskeletal Tumor CenterPeking University People's HospitalBeijingChina
- Beijing Key Laboratory of Musculoskeletal TumorBeijingChina
| | - Ranxin Zhang
- Department of Orthopedic Surgery, Montefiore Medical CenterAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Haijie Liang
- Musculoskeletal Tumor CenterPeking University People's HospitalBeijingChina
- Beijing Key Laboratory of Musculoskeletal TumorBeijingChina
| | - Yingteng Ma
- Department of PathologyPeking University People's HospitalBeijingChina
| | - Alexander Ferrena
- Department of Orthopedic Surgery, Montefiore Medical CenterAlbert Einstein College of MedicineBronxNew YorkUSA
- Department of Genetics, Institute for Clinical and Translational ResearchAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Wei Wang
- Musculoskeletal Tumor CenterPeking University People's HospitalBeijingChina
- Beijing Key Laboratory of Musculoskeletal TumorBeijingChina
| | - Rui Yang
- Department of Orthopedic Surgery, Montefiore Medical CenterAlbert Einstein College of MedicineBronxNew YorkUSA
| | - David S. Geller
- Department of Orthopedic Surgery, Montefiore Medical CenterAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Wei Guo
- Musculoskeletal Tumor CenterPeking University People's HospitalBeijingChina
- Beijing Key Laboratory of Musculoskeletal TumorBeijingChina
| | - Tingting Ren
- Musculoskeletal Tumor CenterPeking University People's HospitalBeijingChina
- Beijing Key Laboratory of Musculoskeletal TumorBeijingChina
| | - Bang H. Hoang
- Department of Orthopedic Surgery, Montefiore Medical CenterAlbert Einstein College of MedicineBronxNew YorkUSA
| | - Xiaodong Tang
- Musculoskeletal Tumor CenterPeking University People's HospitalBeijingChina
- Beijing Key Laboratory of Musculoskeletal TumorBeijingChina
| | - Taiqiang Yan
- Department of OrthopedicsPeking University First HospitalBeijingChina
| |
Collapse
|
2
|
Kucinski JP, Calderon D, Kendall GC. Biological and therapeutic insights from animal modeling of fusion-driven pediatric soft tissue sarcomas. Dis Model Mech 2024; 17:dmm050704. [PMID: 38916046 PMCID: PMC11225592 DOI: 10.1242/dmm.050704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/26/2024] Open
Abstract
Survival for children with cancer has primarily improved over the past decades due to refinements in surgery, radiation and chemotherapy. Although these general therapies are sometimes curative, the cancer often recurs, resulting in poor outcomes for patients. Fusion-driven pediatric soft tissue sarcomas are genetically defined by chromosomal translocations that create a chimeric oncogene. This distinctive, almost 'monogenic', genetic feature supports the generation of animal models to study the respective diseases in vivo. This Review focuses on a subset of fusion-driven pediatric soft tissue sarcomas that have transgenic animal tumor models, which includes fusion-positive and infantile rhabdomyosarcoma, synovial sarcoma, undifferentiated small round cell sarcoma, alveolar soft part sarcoma and clear cell sarcoma. Studies using the animal models of these sarcomas have highlighted that pediatric cancers require a specific cellular state or developmental stage to drive tumorigenesis, as the fusion oncogenes cause different outcomes depending on their lineage and timing of expression. Therefore, understanding these context-specific activities could identify targetable activities and mechanisms critical for tumorigenesis. Broadly, these cancers show dependencies on chromatin regulators to support oncogenic gene expression and co-opting of developmental pathways. Comparative analyses across lineages and tumor models will further provide biological and therapeutic insights to improve outcomes for these children.
Collapse
Affiliation(s)
- Jack P. Kucinski
- Center for Childhood Cancer Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH 43215, USA
- Molecular, Cellular, and Developmental Biology PhD Program, The Ohio State University, Columbus, OH 43210, USA
| | - Delia Calderon
- Center for Childhood Cancer Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH 43215, USA
- Molecular, Cellular, and Developmental Biology PhD Program, The Ohio State University, Columbus, OH 43210, USA
| | - Genevieve C. Kendall
- Center for Childhood Cancer Research, The Abigail Wexner Research Institute, Nationwide Children's Hospital, Columbus, OH 43215, USA
- Molecular, Cellular, and Developmental Biology PhD Program, The Ohio State University, Columbus, OH 43210, USA
- Department of Pediatrics, The Ohio State University College of Medicine, Columbus, OH 43215, USA
| |
Collapse
|
3
|
Kadam SS, Kadam T. Primary Gastric Synovial Sarcoma in a Young Male: a Rare Case Report and Review of Literature. Indian J Surg Oncol 2023; 14:690-693. [PMID: 37900632 PMCID: PMC10611643 DOI: 10.1007/s13193-023-01738-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Accepted: 03/16/2023] [Indexed: 03/31/2023] Open
Abstract
We are reporting a rare case of primary gastric synovial sarcoma in a young male. Synovial sarcoma of the stomach is a very rare tumor. The common involved sites of occurrence of synovial sarcomas are upper and lower extremities. In the English literature, only 47 cases of primary synovial sarcoma of stomach have been reported. Spindle-shaped tumor cells are the basic content of synovial sarcomas with varying degrees of epithelial differentiation. The basic classification of synovial sarcoma depends on the histological pattern and the degree of differentiation and it is classified as monophasic, biphasic, and poorly differentiated. Synovial sarcoma presents with classical chromosomal translocation where they form fusion genes of SS18-SSX1, SS18-SSX2, and SS18-SSX4. Fluorescence in situ hybridization (FISH) and reverse transcription polymerase chain reaction (RT-PCR) are the molecular analysis techniques to detect these fusion genes. As the available literature support is limited, the role of adjuvant chemotherapy, radiation therapy, and intra-operative lymphadenectomy is still unclear. However, surgical resection with clear margin is the gold standard treatment.
Collapse
Affiliation(s)
- Sachin S. Kadam
- Dept of Surgical Oncology, Currae Cancer & Multispeciality Hospital, Mumbai, India
| | - Tejaswini Kadam
- Dept of Ophthalmology, Shree Ramkrishna Netralaya Superspeciality Eye Hospital, Mumbai, India
| |
Collapse
|
4
|
Sacchetti F, Alsina AC, Muratori F, Scoccianti G, Neri E, Kaya H, Sabah D, Capanna R, Campanacci DA. Tumor size and surgical margins are important prognostic factors of synovial sarcoma - A retrospective study. J Orthop 2023; 42:74-79. [PMID: 37533628 PMCID: PMC10391603 DOI: 10.1016/j.jor.2023.07.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2023] [Revised: 06/28/2023] [Accepted: 07/06/2023] [Indexed: 08/04/2023] Open
Abstract
Background Synovial Sarcoma (SS) is a rare soft tissue sarcoma. Mean time to get a SS diagnosis from the onset of symptoms is 10 years, furthermore, SS is associated with late metastasis. Surgery is the main treatment option, whose quality deeply affects SS outcomes, and it can be associated to preoperative or post-operative radiotherapy. Chemotherapy is considered very effective in Children, while in adults its efficacy is still under debate. The aim of this study was to investigate the oncologic results in SS treatment and to identify the risk factors for local and systemic control of the disease. Methods From 1994 to 2018, 211 patients affected by SS were treated in 3 Referral Centres of Orthopaedic Oncology. One hundred seventy-seven patients were included in the study, the median follow-up length was 96 months (5-374). Results Overall Survival on the Kaplan Meier Analyses was 80%, 70% and 56% at 5, 10 and 20 years. In multivariate analyses, OS correlated with tumour size and negative surgical margins. Chemotherapy use wasn't associated with better survival although patients who underwent CT had bigger and more aggressive tumours. Conclusions Our findings suggests that surgery with negative margins is the most important factor in Synovial Sarcoma. Adjuvant treatments as chemotherapy and radiation therapy didn't change the disease's course.
Collapse
Affiliation(s)
| | - Andac Celasun Alsina
- Ege University, Faculty of Medicine, Department of Orthopedics and Traumatology, Turkey
| | | | | | | | - Huseyin Kaya
- Ege University, Faculty of Medicine, Department of Orthopedics and Traumatology, Turkey
| | - Dundar Sabah
- Ege University, Faculty of Medicine, Department of Orthopedics and Traumatology, Turkey
| | | | | |
Collapse
|
5
|
McCool A, Turner C, Turner S, Heppner P, Saran F. Primary intraventricular synovial sarcoma of the brain with recurrence - case presentation. BMC Neurol 2022; 22:447. [PMID: 36456921 PMCID: PMC9713988 DOI: 10.1186/s12883-022-02975-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Accepted: 11/08/2022] [Indexed: 12/05/2022] Open
Abstract
BACKGROUND We report a case of recurrent primary intraventricular synovial sarcoma of the brain with no extracranial primary, initially reported as a haemangiopericytoma. We believe this is the first reported case of primary intraventricular synovial sarcoma at this site. CASE PRESENTATION A 27-year-old male presented to hospital with a new onset of seizures. Imaging revealed a left ventricular trigone mass with surrounding oedema. He underwent a left occipito-temporal craniotomy and resection with the histology reported as haemangiopericytoma. Resection was followed by adjuvant radiation treatment. Seven years later follow-up imaging revealed a 4 mm contrast enhancing lesion in the previous surgical bed. The patient underwent resection. Histological analysis of the recurrence revealed a spindle cell tumour with a SS18 gene rearrangement consistent with synovial sarcoma. Retrospective fluorescent in-situ hybridisation analysis of original histology also revealed a SS18 gene rearrangement consistent with a diagnosis of synovial sarcoma. CONCLUSION Synovial sarcoma should be included as part of the differential diagnosis for patients presenting with intraventricular spindle cell tumours in the brain.
Collapse
Affiliation(s)
- Anna McCool
- grid.414055.10000 0000 9027 2851Department of Radiation Oncology Cancer & Blood Research, Auckland City Hospital, Level 12, Building 1, 1023 Auckland, New Zealand
| | - Clinton Turner
- grid.414055.10000 0000 9027 2851Anatomical Pathology, Auckland City Hospital, Labplus, Auckland, New Zealand
| | - Sarah Turner
- grid.414055.10000 0000 9027 2851Department of Radiation Oncology Cancer & Blood Research, Auckland City Hospital, Level 12, Building 1, 1023 Auckland, New Zealand
| | - Peter Heppner
- grid.414055.10000 0000 9027 2851Department of Neurosurgery, Auckland City Hospital, Auckland, New Zealand
| | - Frank Saran
- grid.414055.10000 0000 9027 2851Department of Radiation Oncology Cancer & Blood Research, Auckland City Hospital, Level 12, Building 1, 1023 Auckland, New Zealand
| |
Collapse
|
6
|
Brashears CB, Prudner BC, Rathore R, Caldwell KE, Dehner CA, Buchanan JL, Lange SE, Poulin N, Sehn JK, Roszik J, Spitzer D, Jones KB, O'Keefe R, Nielsen TO, Taylor EB, Held JM, Hawkins W, Van Tine BA. Malic Enzyme 1 Absence in Synovial Sarcoma Shifts Antioxidant System Dependence and Increases Sensitivity to Ferroptosis Induction with ACXT-3102. Clin Cancer Res 2022; 28:3573-3589. [PMID: 35421237 PMCID: PMC9378556 DOI: 10.1158/1078-0432.ccr-22-0470] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Revised: 03/29/2022] [Accepted: 04/12/2022] [Indexed: 01/09/2023]
Abstract
PURPOSE To investigate the metabolism of synovial sarcoma (SS) and elucidate the effect of malic enzyme 1 absence on SS redox homeostasis. EXPERIMENTAL DESIGN ME1 expression was measured in SS clinical samples, SS cell lines, and tumors from an SS mouse model. The effect of ME1 absence on glucose metabolism was evaluated utilizing Seahorse assays, metabolomics, and C13 tracings. The impact of ME1 absence on SS redox homeostasis was evaluated by metabolomics, cell death assays with inhibitors of antioxidant systems, and measurements of intracellular reactive oxygen species (ROS). The susceptibility of ME1-null SS to ferroptosis induction was interrogated in vitro and in vivo. RESULTS ME1 absence in SS was confirmed in clinical samples, SS cell lines, and an SS tumor model. Investigation of SS glucose metabolism revealed that ME1-null cells exhibit higher rates of glycolysis and higher flux of glucose into the pentose phosphate pathway (PPP), which is necessary to produce NADPH. Evaluation of cellular redox homeostasis demonstrated that ME1 absence shifts dependence from the glutathione system to the thioredoxin system. Concomitantly, ME1 absence drives the accumulation of ROS and labile iron. ROS and iron accumulation enhances the susceptibility of ME1-null cells to ferroptosis induction with inhibitors of xCT (erastin and ACXT-3102). In vivo xenograft models of ME1-null SS demonstrate significantly increased tumor response to ACXT-3102 compared with ME1-expressing controls. CONCLUSIONS These findings demonstrate the translational potential of targeting redox homeostasis in ME1-null cancers and establish the preclinical rationale for a phase I trial of ACXT-3102 in SS patients. See related commentary by Subbiah and Gan, p. 3408.
Collapse
Affiliation(s)
- Caitlyn B. Brashears
- Division of Medical Oncology, Washington University in St. Louis, St. Louis, Missouri
| | - Bethany C. Prudner
- Division of Medical Oncology, Washington University in St. Louis, St. Louis, Missouri
| | - Richa Rathore
- Division of Medical Oncology, Washington University in St. Louis, St. Louis, Missouri
| | - Katharine E. Caldwell
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri
| | - Carina A. Dehner
- Department of Pathology and Immunology, Division of Anatomic and Molecular Pathology, Washington University in St. Louis, St. Louis, Missouri
| | - Jane L. Buchanan
- Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, Iowa
| | - Sara E.S. Lange
- Division of Medical Oncology, Washington University in St. Louis, St. Louis, Missouri
| | - Neal Poulin
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Jennifer K. Sehn
- Department of Pathology and Immunology, Division of Anatomic and Molecular Pathology, Washington University in St. Louis, St. Louis, Missouri
| | - Jason Roszik
- Departments of Melanoma Medical Oncology and Genomic Medicine, The University of Texas MD Anderson Cancer Center, Houston, Texas
| | - Dirk Spitzer
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri.,Siteman Cancer Center, Washington University in St. Louis, St. Louis, Missouri
| | - Kevin B. Jones
- Department of Orthopedics, University of Utah, Salt Lake City, Utah.,Department of Oncological Sciences, University of Utah, Salt Lake City, Utah.,Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah
| | - Regis O'Keefe
- Siteman Cancer Center, Washington University in St. Louis, St. Louis, Missouri.,Department of Orthopedics, Washington University in St. Louis, St. Louis, Missouri
| | - Torsten O. Nielsen
- Department of Pathology and Laboratory Medicine, The University of British Columbia, Vancouver, British Columbia, Canada
| | - Eric B. Taylor
- Department of Molecular Physiology and Biophysics, Carver College of Medicine, University of Iowa, Iowa City, Iowa.,Holden Comprehensive Cancer Center, University of Iowa, Iowa City, Iowa.,Fraternal Order of Eagles Diabetes Research Center, University of Iowa, Iowa City, Iowa
| | - Jason M. Held
- Division of Medical Oncology, Washington University in St. Louis, St. Louis, Missouri.,Siteman Cancer Center, Washington University in St. Louis, St. Louis, Missouri.,Department of Anesthesiology, Washington University in St. Louis, St. Louis, Missouri
| | - William Hawkins
- Department of Surgery, Washington University in St. Louis School of Medicine, St. Louis, Missouri.,Siteman Cancer Center, Washington University in St. Louis, St. Louis, Missouri
| | - Brian A. Van Tine
- Division of Medical Oncology, Washington University in St. Louis, St. Louis, Missouri.,Siteman Cancer Center, Washington University in St. Louis, St. Louis, Missouri.,Department of Pediatrics, Washington University in St. Louis, St. Louis, Missouri.,Corresponding Author: Brian A. Van Tine, Division of Medical Oncology, Washington University in St. Louis, 660 South Euclid, Campus Box 8007, St. Louis, MO 63110. Phone: 314-747-3096: E-mail:
| |
Collapse
|
7
|
Metastasectomy in synovial sarcoma: A systematic review and meta-analysis. Eur J Surg Oncol 2022; 48:1901-1910. [DOI: 10.1016/j.ejso.2022.05.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2022] [Revised: 05/13/2022] [Accepted: 05/26/2022] [Indexed: 11/22/2022] Open
|
8
|
Quan H, Sreekissoon S, Wang Y. Synovial sarcoma of the head and neck: A review of reported cases on the clinical characteristics and treatment methods. Front Cell Dev Biol 2022; 10:1077756. [PMID: 36684451 PMCID: PMC9853006 DOI: 10.3389/fcell.2022.1077756] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/23/2022] [Accepted: 12/12/2022] [Indexed: 01/08/2023] Open
Abstract
Synovial sarcoma (SS) is a high-grade soft-tissue sarcoma that occurs predominantly in older children and young adults in their thirties. It is usually very challenging to diagnose and treat synovial sarcoma in the head and neck region. The purpose of this review is to investigate the clinical manifestations and different treatment methods in the management of primary synovial sarcoma of the head and neck. HNSS has an aggressive nature and poor prognosis. Surgical resection, radiotherapy, and chemotherapy are the primary treatment methods. Typically, surgical resection with negative margins remains the foundation of therapy, which is not very easily achieved in the head and neck due to its complex anatomical structure and the presence of many blood vessels and nerves. However, synovial sarcoma has a high recurrence rate, so aggressive management and close follow-up are warranted for the optimal outcome.
Collapse
Affiliation(s)
- Hongzhi Quan
- Department of Oral Maxillofacial Surgery, Xiangya Stomatological Hospital and School of Stomatology, Central South University, Changsha, Hunan, China
| | - Senjeet Sreekissoon
- Department of Oral Maxillofacial Surgery, Xiangya Stomatological Hospital and School of Stomatology, Central South University, Changsha, Hunan, China
| | - Yan Wang
- School and Hospital of Stomatology, Wenzhou Medical University, Wenzhou, Zhejiang, China
| |
Collapse
|
9
|
Cheng H, Yihebali C, Zhang H, Guo L, Shi S. Clinical Characteristics, Pathology and Outcome of 237 Patients With Synovial Sarcoma: Single Center Experience. Int J Surg Pathol 2021; 30:360-369. [PMID: 34866460 DOI: 10.1177/10668969211056013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/16/2023]
Abstract
BACKGROUND Synovial sarcoma (SS) is a rare soft tissue sarcoma. Available data regarding survival outcomes of patients with SS still remains limited. In this study, a single center retrospective analysis was performed to investigate the clinical characteristics, pathology and survival outcomes in patients with SS in China. METHODS Patient data were systematically reviewed at the National Cancer Center from January 2015 to December 2020. The general information and treatment condition of patients were collected. Overall survival (OS) was evaluated using the Kaplan-Meier and Cox regression method. RESULTS A total of 237 consecutive patients were included in this study (follow-up cut-off date: December, 2020). The median age of patients involved was 35 years (ranging from 5 to 83 years) and the mean tumor diameter was 5.3 cm (ranging from .2 to 26.0 cm). The main findings of the immunohistochemical staining analyses were EMA (111/156) (71%), keratin (32/64) (50.0%), keratin (12/20) (60%), keratin (42/70) (60%), S-100 (18/160) (11%), BCL-2 (128/134) (96%), CD99 (137/148) (93%) and TLE1 (23/26) (88%). It was found that 109 patients (66%) were presented with monophasic subtype and 55 (34%) with biphasic subtype. A total of 137 patients were tested by FISH method and 119 patients (87%) demonstrated SS18 rearrangement, whereas 18 patients (13%) did not show SS18 rearrangement. Generally, it was found that the 3-year OS rate was 86% and the 3-year DFS was 55%. Results of univariate analysis revealed that age, tumor size, tumor site, radiotherapy and targeted therapy were significantly correlated with the overall survival (P < .05). Further, multivariate Cox regression analysis revealed that age, tumor size and radiotherapy were significantly associated with OS (P < .05). CONCLUSIONS In conclusion, this study shows that the outcomes of patients with SS significantly decrease with age and tumor size. It was evident that radiotherapy is an independent and positive prognostic factor for patients with SS. In addition, it was shown that the prognosis of SS varies with tumor location. For instance, primary tumors in lower extremities have a higher prognosis, whereas tumors located in thorax have a lower prognosis.
Collapse
Affiliation(s)
- Hao Cheng
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Chi Yihebali
- Department of Medical Oncology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Hongtu Zhang
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Lei Guo
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| | - Susheng Shi
- Department of Pathology, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China
| |
Collapse
|
10
|
Fiore M, Sambri A, Spinnato P, Zucchini R, Giannini C, Caldari E, Pirini MG, De Paolis M. The Biology of Synovial Sarcoma: State-of-the-Art and Future Perspectives. Curr Treat Options Oncol 2021; 22:109. [PMID: 34687366 PMCID: PMC8541977 DOI: 10.1007/s11864-021-00914-4] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/20/2021] [Indexed: 12/22/2022]
Abstract
New molecular insights are being achieved in synovial sarcoma (SS) that can provide new potential diagnostic and prognostic markers as well as therapeutic targets. In particular, the advancement of research on epigenomics and gene regulation is promising. The concrete hypothesis that the pathogenesis of SS might mainly depend on the disruption of the balance of the complex interaction between epigenomic regulatory complexes and the consequences on gene expression opens interesting new perspectives. The standard of care for primary SS is wide surgical resection combined with radiation in selected cases. The role of chemotherapy is still under refinement and can be considered in patients at high risk of metastasis or in those with advanced disease. Cytotoxic chemotherapy (anthracyclines, ifosfamide, trabectedin, and pazopanib) is the treatment of choice, despite several possible side effects. Many possible drug-able targets have been identified. However, the impact of these strategies in improving SS outcome is still limited, thus making current and future research strongly needed to improve the survival of patients with SS.
Collapse
Affiliation(s)
- Michele Fiore
- Alma Mater Studiorum - University of Bologna, Bologna, Italy
| | - Andrea Sambri
- Alma Mater Studiorum - University of Bologna, Bologna, Italy. .,IRCCS Azienda Ospedaliero Universitaria di Bologna, via Massarenti 9, 40138, Bologna, Italy.
| | | | | | | | - Emilia Caldari
- IRCCS Azienda Ospedaliero Universitaria di Bologna, via Massarenti 9, 40138, Bologna, Italy
| | - Maria Giulia Pirini
- IRCCS Azienda Ospedaliero Universitaria di Bologna, via Massarenti 9, 40138, Bologna, Italy
| | - Massimiliano De Paolis
- IRCCS Azienda Ospedaliero Universitaria di Bologna, via Massarenti 9, 40138, Bologna, Italy
| |
Collapse
|
11
|
Primary gastric synovial sarcoma resected by laparoscopic endoscopic cooperative surgery of the stomach: a case report. Surg Case Rep 2021; 7:225. [PMID: 34669095 PMCID: PMC8528932 DOI: 10.1186/s40792-021-01310-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2021] [Accepted: 10/12/2021] [Indexed: 11/10/2022] Open
Abstract
Background Primary gastric synovial sarcoma is extremely rare, only 44 cases have been reported so far, and there have been no reports of laparoscopic endoscopic cooperative surgery for this condition. Case presentation A 45-year-old male patient presented with gastric pain. Esophagogastroduodenoscopy was performed that led to the identification of an 8-mm submucosal tumor in the anterior wall of the antrum, and a kit-negative gastrointestinal stromal tumor was suspected following biopsy. On endoscopic ultrasonography, the boundary of the tumor, mainly composed of the second layer, was depicted as a slightly unclear low-echo region, and a pointless no echo region was scattered inside. A boring biopsy revealed synovial sarcoma. Positron emission tomography did not reveal fluorodeoxyglucose (18F-FDG) accumulation in the stomach or other organs. Thus, the patient was diagnosed with a primary gastric synovial sarcoma, and laparoscopic endoscopic cooperative surgery was performed. The tumor of the antrum could not be confirmed laparoscopically from the serosa, and under intraoperative endoscopy, it had delle on the mucosal surface, which was removed by a method that does not involve releasing the gastric wall. Immunohistochemistry showed that the spindle cells were positive for EMA, BCL-2 protein, TLE-1, and SS18-SSX fusion-specific antibodies but negative for KIT and DOG-1. The final pathological diagnosis was synovial sarcoma of the stomach. The postoperative course was good, and the patient was discharged from the hospital on the 11th postoperative day. Conclusion Resection with laparoscopic endoscopic cooperative surgery (LECS), which has not been reported before, was effective for small synovial sarcomas that could not be confirmed laparoscopically. With the combination of laparoscopic and endoscopic approaches to neoplasia with a non-exposure technique (CLEAN-NET) procedure, it was possible to excise the tumor with the minimum excision range of the gastric serosa without opening the stomach. Supplementary Information The online version contains supplementary material available at 10.1186/s40792-021-01310-8.
Collapse
|
12
|
Evans DR, Lazarides AL, Cullen MM, Somarelli JA, Blazer DG, Visguass JD, Brigman BE, Eward WC. Identifying Modifiable and Non-modifiable Risk Factors of Readmission and Short-Term Mortality in Chondrosarcoma: A National Cancer Database Study. Ann Surg Oncol 2021; 29:1392-1408. [PMID: 34570333 DOI: 10.1245/s10434-021-10802-8] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2021] [Accepted: 08/31/2021] [Indexed: 11/18/2022]
Abstract
BACKGROUND Limited data are available to inform the risk of readmission and short-term mortality in musculoskeletal oncology. The goal of this study was to identify factors independently associated with 30-day readmission and 90-day mortality following surgical resection of chondrosarcoma. METHODS We retrospectively reviewed 6653 patients following surgical resection of primary chondrosarcoma in the National Cancer Database (2004-2017). Both demographic and clinicopathologic variables were assessed for correlation with readmission and short-term mortality utilizing univariate and multivariate logistic regression modeling. RESULTS Of 220 readmissions (3.26%), risk factors independently associated with an increased risk of unplanned 30-day readmission included Charlson-Deyo Comorbidity Index (CDCC) (odds ratio [OR] 1.31; p = 0.027), increasing American Joint Committee on Cancer (AJCC) stage (OR 1.31; p = 0.004), undergoing major amputation (OR 2.38; p = 0.001), and axial skeletal location (OR 1.51; p = 0.028). A total of 137 patients died within 90 days of surgery (2.25%). Risk factors associated with increased mortality included the CDCC (OR 1.60; p = 0.001), increasing age (OR 1.06; p < 0.001), having Medicaid insurance status (OR 3.453; p = 0.005), living in a zip code with a higher educational attainment (OR 1.59; p = 0.003), increasing AJCC stage (OR 2.32; p < 0.001), longer postoperative length of stay (OR 1.015; p = 0.033), and positive surgical margins (OR 2.75; p = 0.001). Although a majority of the cohort did not receive radiation therapy (88.8%), receiving radiotherapy (OR 0.132; p = 0.010) was associated with a decreased risk of short-term mortality. CONCLUSIONS Several tumor, treatment, and patient factors can help inform the risk of readmission and short-term mortality in patients with surgically treated chondrosarcoma.
Collapse
Affiliation(s)
| | | | | | - Jason A Somarelli
- Duke Cancer Institute, Duke University Hospital, Durham, NC, USA.,Department of Medicine, Duke University Hospital, Durham, NC, USA
| | - Dan G Blazer
- Duke Cancer Institute, Duke University Hospital, Durham, NC, USA.,Department of Surgery, Duke University Hospital, Durham, NC, USA
| | - Julia D Visguass
- Department of Orthopaedic Surgery, Duke University Hospital, Durham, NC, USA.,Duke Cancer Institute, Duke University Hospital, Durham, NC, USA
| | - Brian E Brigman
- Department of Orthopaedic Surgery, Duke University Hospital, Durham, NC, USA.,Duke Cancer Institute, Duke University Hospital, Durham, NC, USA
| | - William C Eward
- Department of Orthopaedic Surgery, Duke University Hospital, Durham, NC, USA.,Duke Cancer Institute, Duke University Hospital, Durham, NC, USA
| |
Collapse
|
13
|
Hannoun B, Hannoun I, Bara A, Alassaf A, Chatty EM. Synovial sarcoma of the maxillary sinus - A rare condition managed with a rationalized surgery. Ann Med Surg (Lond) 2021; 67:102538. [PMID: 34276985 PMCID: PMC8267481 DOI: 10.1016/j.amsu.2021.102538] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/12/2021] [Revised: 07/01/2021] [Accepted: 07/02/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction and importance: Synovial sarcoma is a type of spindle cell tumors with unknown cellular origin. It can present anywhere throughout the body; however, its onset in the maxillary sinus is an extremely rare condition, making it hard to diagnose. This tumor occurs equally, without predilection for males or females, and the incidence peaks in the age of 35. The diagnosis is confirmed by histopathological study, and the main treatment is complete surgical excision. Case presentation We are reporting a case of a 53-year-old male with a left sided hearing loss accompanied by a left sided nasal block and a vague facial and dental pain. Clinical discussion Magnetic Resonance Imaging (MRI) showed a heterogeneously enhancing tumor in the maxillary sinus that extended to the pterygopalatine fossa and other surrounding structures, and a biopsy showed the tumor to be a synovial sarcoma. The tumor was managed with a less aggressive curative surgery, and was put on an adjuvant radiotherapy, and is being followed regularly; with no recurrence 5 months after therapy. Conclusion In conclusion, we are writing this report to introduce a case of synovial sarcoma in a rare location that was managed by a “cosmetically oriented” curative surgery, satisfactory results and prognosis. Synovial sarcoma is a rare type of spindle cell tumors. Synovial sarcoma of the maxillary sinus is a quite rare condition. The term “synovial sarcoma” is an old misnomer. The cellular origin of Synovial sarcoma is still unknown. The main treatment for synovial sarcoma is surgical excision.
Collapse
Affiliation(s)
- Burhan Hannoun
- Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Ibrahim Hannoun
- Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Albaraa Bara
- Faculty of Dentistry, Damascus University, Damascus, Syrian Arab Republic
| | - Areej Alassaf
- Faculty of Medicine, Damascus University, Syrian Arab Republic.,Al-Mouassat University Hospital, Syria
| | - Eyad M Chatty
- Syrian College of Pathologists, Department of Pathology, Alassad University Hospital, Damascus, Syria.,Department of Pathology, Mowasat University Hospital, Damascus, Syria.,Board of Trustees, Kalamoon University, Damascus, Syria
| |
Collapse
|
14
|
Synovial Sarcoma: A Clinical Review. ACTA ACUST UNITED AC 2021; 28:1909-1920. [PMID: 34069748 PMCID: PMC8161765 DOI: 10.3390/curroncol28030177] [Citation(s) in RCA: 73] [Impact Index Per Article: 24.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 05/16/2021] [Accepted: 05/17/2021] [Indexed: 01/26/2023]
Abstract
Synovial sarcomas (SS) represent a unique subset of soft tissue sarcomas (STS) and account for 5–10% of all STS. Synovial sarcoma differs from other STS by the relatively young age at diagnosis and clinical presentation. Synovial sarcomas have unique genomic characteristics and are driven by a pathognomonic t(X;18) chromosomal translocation and subsequent formation of the SS18:SSX fusion oncogenes. Similar to other STS, diagnosis can be obtained from a combination of history, physical examination, magnetic resonance imaging, biopsy and subsequent pathology, immunohistochemistry and molecular analysis. Increasing size, age and tumor grade have been demonstrated to be negative predictive factors for both local disease recurrence and metastasis. Wide surgical excision remains the standard of care for definitive treatment with adjuvant radiation utilized for larger and deeper lesions. There remains controversy surrounding the role of chemotherapy in the treatment of SS and there appears to be survival benefit in certain populations. As the understanding of the molecular and immunologic characteristics of SS evolve, several potential systematic therapies have been proposed.
Collapse
|
15
|
Hashimoto Y, Tome Y, Oshiro H, Aoki Y, Maehara H, Nishida K. Reconstruction of the elbow using pedicle joint freezing after wide excision for soft tissue sarcoma: A case report. Mol Clin Oncol 2021; 14:115. [PMID: 33903821 PMCID: PMC8060848 DOI: 10.3892/mco.2021.2277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/02/2020] [Accepted: 03/19/2021] [Indexed: 11/05/2022] Open
Abstract
A 35-year-old man presented with a four-year history of a growing mass on the anterior aspect of his left elbow. Magnetic resonance imaging revealed a soft tissue tumor in the brachialis muscle extending to the cubital fossa. Following an open biopsy, the tumor was diagnosed as a monophasic fibrous synovial sarcoma. After neoadjuvant chemotherapy, the patient underwent wide excision and reconstruction of the elbow joint with a pedicle frozen autograft. At the final follow-up four years after surgery, the elbow range of motion was 0-120˚. Although there were signs of osteoarthritis, there was no narrowing of the joint -, and the patient experienced only mild pain. To the best of our knowledge, the present case report is the first to describe wide tumor excision and reconstruction using a pedicle frozen autograft of the elbow. This method should be considered after excision of malignant bone and soft tissue tumors, especially in non-weight-bearing joints. Further cases have to be evaluated to understand the complications and long-term prognosis of this procedure.
Collapse
Affiliation(s)
- Yuta Hashimoto
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0125, Japan
| | - Yasunori Tome
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0125, Japan
| | - Hiromichi Oshiro
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0125, Japan
| | - Yusuke Aoki
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0125, Japan
| | - Hiroki Maehara
- Department of Hyperbaric Medicine, University of the Ryukyus Hospital, Nishihara, Okinawa 903-0125, Japan
| | - Kotaro Nishida
- Department of Orthopedic Surgery, Graduate School of Medicine, University of the Ryukyus, Nishihara, Okinawa 903-0125, Japan
| |
Collapse
|
16
|
Kyriazoglou A, Timmermans I, De Cock L, Laenen A, Dumez H, Sinnaeve F, Wafa H, Hompes D, Van Raemdonck D, De Leyn P, Sciot R, Hauben E, Debiec-Rychter M, Vandenbempt I, Schöffski P. Management of Synovial Sarcoma in a Tertiary Referral Center: A Retrospective Analysis of 134 Patients. Oncol Res Treat 2021; 44:232-241. [PMID: 33756486 DOI: 10.1159/000515112] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Accepted: 02/08/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND Synovial sarcomas (SS) are malignant mesenchymal neoplasms that account for about 10% of all sarcomas. Complete surgical excision is the mainstay of primary treatment for localized disease, but SS have a high tendency for local relapse and metastases. Metastatic disease is commonly treated with systemic chemotherapy. METHODS We designed a retrospective analysis to describe the clinical presentation, course of treatment, outcome, and prognosis of patients with SS. Univariate and multivariate analyses were performed for potential prognostic factors. RESULTS We identified 134 patients treated between 1987 and 2018, with a cutoff date of December 2018. Demographics, disease characteristics, treatment, and survival rates were collected and analyzed. The median overall survival (mOS) from the date of diagnosis was 96.7 months. The median progression-free survival was 6.37 months. Disease-free survival was 26 months. Age over 65 years was found to be a prognostic factor with statistically significant value in the univariate analysis regarding mOS (p = 0.015) and mOS after local relapse (p = 0.0228). CONCLUSIONS Even though our study is limited by the retrospective nature of the analysis, it adds an important amount of clinical data regarding the treatment and outcome of SS.
Collapse
Affiliation(s)
| | - Iris Timmermans
- Department of Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Lore De Cock
- Department of Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Annouschka Laenen
- Department of Biostatistics, Catholic University of Leuven, Leuven, Belgium
| | - Herlinde Dumez
- Department of Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Friedl Sinnaeve
- Department of Orthopedic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Hazem Wafa
- Department of Orthopedic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Daphne Hompes
- Department of Surgical Oncology, University Hospitals Leuven, Leuven, Belgium
| | - Dirk Van Raemdonck
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Paul De Leyn
- Department of Thoracic Surgery, University Hospitals Leuven, Leuven, Belgium
| | - Raf Sciot
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | - Esther Hauben
- Department of Pathology, University Hospitals Leuven, Leuven, Belgium
| | | | | | - Patrick Schöffski
- Department of Medical Oncology, University Hospitals Leuven, Leuven, Belgium
| |
Collapse
|
17
|
Dorovinis P, Machairas N, Kykalos S, Stamopoulos P, Agrogiannis G, Nikiteas N, Sotiropoulos GC. Staged Surgical Resection of Primary Pulmonary Synovial Sarcoma with Synchronous Multiple Pancreatic Metastases: Report of a Rare Case and Review of the Literature. J Gastrointest Cancer 2021; 52:1151-1155. [PMID: 33616842 DOI: 10.1007/s12029-021-00604-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/03/2021] [Indexed: 11/24/2022]
Affiliation(s)
- Panagiotis Dorovinis
- Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Nikolaos Machairas
- Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece.
| | - Stylianos Kykalos
- Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Paraskevas Stamopoulos
- Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - George Agrogiannis
- Department of Pathology, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Nikolaos Nikiteas
- Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| | - Georgios C Sotiropoulos
- Department of Propaedeutic Surgery, National and Kapodistrian University of Athens, Medical School, Athens, Greece
| |
Collapse
|
18
|
Kozak K, Teterycz P, Świtaj T, Koseła-Paterczyk H, Falkowski S, Morysiński T, Bartnik E, Czarnecka AM, Wągrodzki M, Ługowska I, Rutkowski P. The Long-Term Outcomes of Intensive Combined Therapy of Adult Patients with Localised Synovial Sarcoma. J Clin Med 2020; 9:jcm9103129. [PMID: 32998194 PMCID: PMC7601566 DOI: 10.3390/jcm9103129] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 09/21/2020] [Accepted: 09/24/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction: Synovial sarcoma (SaSy) is a high-grade, malignant soft tissue sarcoma (STS) accounting for 5–9% of STS. The aim of this study was to analyse outcomes of patients with localised SaSy treated in a single institution with a uniform neo- and adjuvant-combined therapy protocol. Methods: 171 patients with stage II/III SaSy were treated between 1997 and 2014. Chemotherapy consisted of 4 cycles of ifosfamide 12 g/m2 and two cycles of a doxorubicin-based regimen 75 mg/m2. With the exception of patients who underwent amputation, all patients received neoadjuvant radiotherapy. Results: Median age was 33 years (range 17–69). Tumours larger than 5 cm in size were found in 70% of patients. The 5-year overall survival (OS), local relapse-free survival (LRFS) and metastasis-free survival (MFS) rates were 75%, 80% and 60%, respectively. In multivariate Cox’s regression, age > 35 years, male sex, larger tumour size and histology other than monophasic were associated with worse OS. Conclusions: In adult patients with localised SaSy, long-term survival can be achieved in a significant proportion of cases with intensive combined therapy. The multivariate analysis identified age, sex, disease stage and histology subtype as independent prognostic factors of OS.
Collapse
Affiliation(s)
- Katarzyna Kozak
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.T.); (T.Ś.); (H.K.-P.); (S.F.); (T.M.); (A.M.C.); (I.Ł.); (P.R.)
- Correspondence:
| | - Paweł Teterycz
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.T.); (T.Ś.); (H.K.-P.); (S.F.); (T.M.); (A.M.C.); (I.Ł.); (P.R.)
| | - Tomasz Świtaj
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.T.); (T.Ś.); (H.K.-P.); (S.F.); (T.M.); (A.M.C.); (I.Ł.); (P.R.)
| | - Hanna Koseła-Paterczyk
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.T.); (T.Ś.); (H.K.-P.); (S.F.); (T.M.); (A.M.C.); (I.Ł.); (P.R.)
| | - Sławomir Falkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.T.); (T.Ś.); (H.K.-P.); (S.F.); (T.M.); (A.M.C.); (I.Ł.); (P.R.)
| | - Tadeusz Morysiński
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.T.); (T.Ś.); (H.K.-P.); (S.F.); (T.M.); (A.M.C.); (I.Ł.); (P.R.)
| | - Ewa Bartnik
- Institute of Genetics and Biotechnology, Faculty of Biology, University of Warsaw, 02-106 Warsaw, Poland;
- Institute of Biochemistry and Biophysics, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Anna M. Czarnecka
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.T.); (T.Ś.); (H.K.-P.); (S.F.); (T.M.); (A.M.C.); (I.Ł.); (P.R.)
- Department of Experimental Pharmacology, Mossakowski Medical Research Centre, Polish Academy of Sciences, 02-106 Warsaw, Poland
| | - Michał Wągrodzki
- Department of Pathology and Laboratory Medicine, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland;
| | - Iwona Ługowska
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.T.); (T.Ś.); (H.K.-P.); (S.F.); (T.M.); (A.M.C.); (I.Ł.); (P.R.)
- Early Phase Clinical Trials Unit, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland
| | - Piotr Rutkowski
- Department of Soft Tissue/Bone Sarcoma and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland; (P.T.); (T.Ś.); (H.K.-P.); (S.F.); (T.M.); (A.M.C.); (I.Ł.); (P.R.)
| |
Collapse
|
19
|
Scheer M, Blank B, Bauer S, Vokuhl C, Stegmaier S, Feuchtgruber S, Henssen A, Sparber-Sauer M, Eggert A, Handgretinger R, Pekrun A, Rossig C, Rutkowski S, Schlegel PG, Schrappe M, Simon T, Kazanowska B, Niggli F, Ladenstein R, Ljungman G, Jahnukainen K, Fuchs J, Bielack SS, Koscielniak E, Klingebiel T. Synovial sarcoma disease characteristics and primary tumor sites differ between patient age groups: a report of the Cooperative Weichteilsarkom Studiengruppe (CWS). J Cancer Res Clin Oncol 2020; 146:953-960. [PMID: 31932909 DOI: 10.1007/s00432-019-03121-9] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2019] [Accepted: 12/24/2019] [Indexed: 02/07/2023]
Abstract
BACKGROUND Older age is associated with worse outcome in synovial sarcoma (SS) patients. Differences in disease presentation among distinct age groups, however, are currently unknown. METHODS SS patients < 21 years registered in consecutive CWS trials over the period of 1981-2018 were evaluated. Characteristics were analyzed according to age groups using the Fisher's exact test. RESULTS The study population included 432 SS patients. Disease characteristics differed according to age groups of children (0-12 years, n = 176), adolescents (13-16 years, n = 178), and young adults (17-21 years, n = 78). The proportion of invasive tumors (T2) was significantly higher in older patients: children 33%, adolescents 39% and young adults 54%, p = 0.009805. Similarly, the proportion of tumors > 10 cm was higher (13%, 21%, 31%; p = 0.005657) whereas conversely, the proportion of small tumors < 3 cm was lower in older patients (29%, 24%, 6%; p = 0.000104). The presence of metastases at first diagnosis was also highest in older patients (6%, 10%, 21%, p = 0.000963). Notably, the proportion of thigh tumors was higher in older patients (p = 0.04173), whereas the proportion of head-neck tumors was lower in older patients (p = 0.08896). CONCLUSIONS The rates of large, invasive tumors and the presence of metastases are significantly associated with older patient age. Localization to the thigh is more frequent in older patients. DISCUSSION The causes for these variations require further exploration.
Collapse
Affiliation(s)
- Monika Scheer
- Klinikum Stuttgart, Olgahospital, Pediatrics 5 (Oncology, Hematology, Immunology), Kriegsbergstrasse 62, 70174, Stuttgart, Germany.
| | - Bernd Blank
- Klinikum Stuttgart, Olgahospital, Pediatrics 5 (Oncology, Hematology, Immunology), Kriegsbergstrasse 62, 70174, Stuttgart, Germany
| | - Sebastian Bauer
- Sarcoma Center, West German Cancer Center, University of Duisburg-Essen, Essen, Germany
| | - Christian Vokuhl
- Kiel Paediatric Tumor Registry, Department of Paediatric Pathology, University Hospital of Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Sabine Stegmaier
- Klinikum Stuttgart, Olgahospital, Pediatrics 5 (Oncology, Hematology, Immunology), Kriegsbergstrasse 62, 70174, Stuttgart, Germany
| | - Simone Feuchtgruber
- Klinikum Stuttgart, Olgahospital, Pediatrics 5 (Oncology, Hematology, Immunology), Kriegsbergstrasse 62, 70174, Stuttgart, Germany
| | - Anton Henssen
- Department of Pediatric Hematology and Oncology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Monika Sparber-Sauer
- Klinikum Stuttgart, Olgahospital, Pediatrics 5 (Oncology, Hematology, Immunology), Kriegsbergstrasse 62, 70174, Stuttgart, Germany
| | - Angelika Eggert
- Department of Pediatric Hematology and Oncology, Charité-Universitätsmedizin Berlin, Berlin, Germany
| | - Ruppert Handgretinger
- Department of Pediatric Hematology and Oncology, University Children's Hospital, University Hospital Tuebingen, Tuebingen, Germany
| | - Arnulf Pekrun
- Department of Pediatric Hematology and Oncology, Hospital Bremen-Mitte, Bremen, Germany
| | - Claudia Rossig
- Department of Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany
| | - Stefan Rutkowski
- Pediatric Hematology and Oncology, University Hamburg-Eppendorf, Hamburg, Germany
| | - Paul-Gerhardt Schlegel
- University Children's Hospital, Pediatric Oncology, Hematology, Stem Cell Transplantation, University of Wuerzburg, Wuerzburg, Germany
| | - Martin Schrappe
- Department of Pediatrics, University Hospital Schleswig-Holstein, Campus Kiel, Kiel, Germany
| | - Thorsten Simon
- Department of Pediatric Oncology and Hematology, University Children's Hospital of Cologne, Medical Faculty, Cologne, Germany
| | | | - Felix Niggli
- Department of Pediatric Oncology, University of Zuerich, Zuerich, Switzerland
| | - Ruth Ladenstein
- St. Anna Kinderspital and St. Anna Kinderkrebsforschung e.V., Vienna, Austria
| | - Gustaf Ljungman
- Department of Women's and Children's Health, Uppsala University, Uppsala, Sweden
| | - Kirsi Jahnukainen
- New Children's Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - Jörg Fuchs
- Department of Pediatric Surgery and Urology, University Children's Hospital, Tuebingen, Germany
| | - Stefan S Bielack
- Klinikum Stuttgart, Olgahospital, Pediatrics 5 (Oncology, Hematology, Immunology), Kriegsbergstrasse 62, 70174, Stuttgart, Germany.,Department of Pediatric Hematology and Oncology, University Children's Hospital Muenster, Muenster, Germany
| | - Ewa Koscielniak
- Klinikum Stuttgart, Olgahospital, Pediatrics 5 (Oncology, Hematology, Immunology), Kriegsbergstrasse 62, 70174, Stuttgart, Germany.,Department of Pediatric Hematology and Oncology, University Children's Hospital, University Hospital Tuebingen, Tuebingen, Germany
| | - Thomas Klingebiel
- Hospital for Children and Adolescents, Goethe-University, Frankfurt (Main), Germany
| | | |
Collapse
|
20
|
Matsuo S, Tomita E, Fukuhara K, Akashi A, Tsukamoto Y. Two cases of poorly differentiated synovial sarcoma arising from the chest wall - One case of Ewing sarcoma-like small cell type with death 4 years after the first presentation and one case of high-grade spindle cell type receiving postoperative adjuvant chemotherapy. HUMAN PATHOLOGY: CASE REPORTS 2019. [DOI: 10.1016/j.ehpc.2019.200329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
|
21
|
Khan M, Rankin KS, Todd R, Lethbridge E, Gerrand C. Surgical excision and not chemotherapy is the most powerful modality in treating synovial sarcoma: the UK's North East experience. Arch Orthop Trauma Surg 2019; 139:443-449. [PMID: 30406818 DOI: 10.1007/s00402-018-3059-x] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/06/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND AND PURPOSE We reviewed our experience of synovial sarcoma to identify factors predictive of local recurrence and overall survival, the impact of chemotherapy and outcomes after surgical excision alone. MATERIALS AND METHODS 81 patients were treated between 1997 and 2014 of mean age 39 years (8-78). Tumours were in the extremity in 55 (67%). 9 patients presented with metastases and 10 with unresectable disease. Mean follow-up was 3.7 years (SD 3.8). Treatment groups were palliative, surgery only, surgery and radiotherapy, or surgery with chemotherapy (with or without radiotherapy). RESULTS Local recurrence-free survival (LRFS) was 73% at 5 years, and 68% at 10 and 15 years. In multivariate analysis, positive surgical margins were an independent predictor of LRFS. Overall survival (OS) was 50% at 5 years for all patients, and 62% at 5 years for those treated with curative intent. Larger tumour size and non-extremity locations were predictors of poorer OS. Patients who had chemotherapy did not have significantly better OS or LRS than others. INTERPRETATION These results show that where feasible, curative resection should not be delayed for chemotherapy. Treatment with surgery only can be associated with good outcomes in selected patients with smaller extremity tumours; although our series is small.
Collapse
Affiliation(s)
- Munir Khan
- Shaheed Zulfiqar Ali Bhutto Medical University/PIMS Hospital, Islamabad, Pakistan.
| | - Kenneth S Rankin
- North of England Bone and Soft Tissue Tumour Service, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK
| | - Radha Todd
- Freeman Hospital, Newcastle Upon Tyne, UK
| | | | - Craig Gerrand
- London Sarcoma Service, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK
| |
Collapse
|
22
|
Darraj E, Hotait H, Abdulghafoor Y, Jabbr M. Hypopharyngeal synovial sarcoma: A case report and literature review. HAMDAN MEDICAL JOURNAL 2019. [DOI: 10.4103/hmj.hmj_63_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
23
|
|
24
|
Scheer M, Greulich M, Loff S, Vokuhl C, Feuchtgruber S, Kalle T, Münter M, Stegmaier S, Sparber‐Sauer M, Kazanowska B, Niggli F, Fuchs J, Bielack SS, Klingebiel T, Koscielniak E. Localized synovial sarcoma of the foot or ankle: A series of 32 Cooperative Weichteilsarkom Study Group patients. J Surg Oncol 2018; 119:109-119. [DOI: 10.1002/jso.25284] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Accepted: 10/10/2018] [Indexed: 12/19/2022]
Affiliation(s)
- Monika Scheer
- Pediatrics 5 (Oncology, Hematology, Immunology), Olgahospital, Klinikum StuttgartStuttgart Germany
| | - Michael Greulich
- Pediatric Surgery, Olgahospital, Klinikum StuttgartStuttgart Germany
| | - Steffan Loff
- Pediatric Surgery, Olgahospital, Klinikum StuttgartStuttgart Germany
| | - Christian Vokuhl
- Department of Pediatric Pathology, Kiel Paediatric Tumor Registry, University Hospital of Schleswig‐HolsteinCampus Kiel Germany
| | - Simone Feuchtgruber
- Pediatrics 5 (Oncology, Hematology, Immunology), Olgahospital, Klinikum StuttgartStuttgart Germany
| | - Thekla Kalle
- Pediatric Radiology, Radiologisches Institut, Olgahospital, Klinikum StuttgartStuttgart Germany
| | - Marc Münter
- Department of Radiation OncologyKlinikum StuttgartStuttgart Germany
| | - Sabine Stegmaier
- Pediatrics 5 (Oncology, Hematology, Immunology), Olgahospital, Klinikum StuttgartStuttgart Germany
| | - Monika Sparber‐Sauer
- Pediatrics 5 (Oncology, Hematology, Immunology), Olgahospital, Klinikum StuttgartStuttgart Germany
| | | | - Felix Niggli
- Department of Pediatric OncologyUniversity of ZuerichZuerich Switzerland
| | - Jörg Fuchs
- Department of Pediatric Surgery and UrologyUniversity Children’s HospitalTuebingen Germany
| | - Stefan S. Bielack
- Pediatrics 5 (Oncology, Hematology, Immunology), Olgahospital, Klinikum StuttgartStuttgart Germany
- Department of Pediatric Hematology and OncologyUniversity Children’s HospitalMuenster Germany
| | - Thomas Klingebiel
- Hospital for Children and Adolescents, Goethe‐University Frankfurt (Main)Frankfurt Germany
| | - Ewa Koscielniak
- Pediatrics 5 (Oncology, Hematology, Immunology), Olgahospital, Klinikum StuttgartStuttgart Germany
- Department of Pediatric OncologyUniversity of TuebingenTuebingen Germany
| | | |
Collapse
|
25
|
Myxoid Liposarcoma: Treatment Outcomes from Chemotherapy and Radiation Therapy. Sarcoma 2018; 2018:8029157. [PMID: 30515050 PMCID: PMC6236966 DOI: 10.1155/2018/8029157] [Citation(s) in RCA: 26] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/03/2018] [Accepted: 10/10/2018] [Indexed: 12/21/2022] Open
Abstract
Introduction Myxoid liposarcoma (MLS) is a subtype of liposarcoma characterized morphologically by lipomatous differentiation with a myxoid stroma. The purpose of this study was to review clinical and pathological information for patients treated for MLS at our institution to better understand neoadjuvant and adjuvant therapy. Materials and Methods An institutional database of sarcomas was queried for patients who were treated for MLS at our institution between 1992 and 2013. Survival curves were constructed using Kaplan–Meier analysis, and univariate and multivariate statistics were performed using the Cox-proportional hazards model and using linear regression. Results A total of 85 patients with myxoid liposarcoma were identified. The mean and median histologic response rate to treatment for patients who received preoperative radiation therapy was 77.6%. Five-year disease-free survival, distant metastasis-free survival, local recurrence-free survival, and overall survival were 78.6% (95% CI: 67.8–86.1), 84.7% (95% CI: 74.5–91.0), 95.6% (95% CI: 86.9–98.6), and 87.5% (95% CI: 77.2–93.3) respectively. On univariate analysis, there was a trend towards higher necrosis or treatment response rates in patients who received concurrent chemotherapy, 84.7% (95% CI: 75.9–93.4) and 69.5% (95% CI: 55.1–83.8), p=0.061. Tumor size was associated with inferior disease-free and overall survival. Hazard ratio for disease-free survival is 1.08 (per cm) (95% CI: 1.01–1.16), p=0.019. Conclusions Myxoid liposarcoma exhibits histological response to chemotherapy and radiation therapy. Tumor size appears to be greatest predictor of long-term disease control and overall survival. We were not able to show that chemotherapy provides a clinical benefit with regard to local control, disease-free survival, or overall survival. However, it is important to note that the selected usage of chemotherapy in the highest risk patients confounds this analysis. Further investigation is needed to help better determine the optimal use of chemotherapy in this group of patients.
Collapse
|
26
|
Riedel RF, Jones RL, Italiano A, Bohac C, Thompson JC, Mueller K, Khan Z, Pollack SM, Van Tine BA. Systemic Anti-Cancer Therapy in Synovial Sarcoma: A Systematic Review. Cancers (Basel) 2018; 10:cancers10110417. [PMID: 30388821 PMCID: PMC6267101 DOI: 10.3390/cancers10110417] [Citation(s) in RCA: 34] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2018] [Revised: 10/29/2018] [Accepted: 10/30/2018] [Indexed: 12/14/2022] Open
Abstract
Synovial sarcoma (SS) is an aggressive malignancy which accounts for approximately 5–10% of all soft-tissue sarcomas. SS has pathologic and genomic characteristics that define it as a distinct subtype of soft tissue sarcoma (STS). STS subtypes continue to be recognized as distinct entities with specific characteristics, including differential chemo-sensitivity. The objective of this study was to conduct a descriptive review of current data on survival outcomes of systemic anti-cancer therapy specific to SS. A systematic literature review was conducted, using a custom search strategy to search EMBASE, Medline and CENTRAL for clinical trials and observational studies reporting overall survival (OS), progression-free survival (PFS) and/or response for cohorts of at least 50 SS patients. We identified 28 studies meeting these criteria, 25 of which were retrospective studies. Only three prospective studies were identified. Survival reports varied widely between studies based on the population, in particular on the disease stage, and reporting was heterogeneous in terms of the time points reported on. For patients with localized disease, reports of five-year PFS ranged from 26% to 80.7% and five-year OS from 40% to 90.7%, whereas five-year OS for patients with metastatic disease was very low at around 10%; and in one case, 0% was reported. Only four of the included publications reported outcomes by type of systemic anti-cancer therapy received. Our study draws attention to the fact that additional prospective studies to better define the most appropriate treatment for SS in all stages and lines of therapy are still needed.
Collapse
Affiliation(s)
- Richard F Riedel
- Duke Cancer Institute, Duke University Health System, Durham, NC 27710, USA.
| | - Robin L Jones
- The Royal Marsden NHS Foundation Trust, Institute of Cancer Research, London SM2 5NG, UK.
| | - Antoine Italiano
- Department of Medical Oncology, Institute Bergonié, 33000 Bordeaux, France.
| | - Chet Bohac
- Immune Design Corporation, San Francisco, CA 94080, USA.
| | | | | | - Zaeem Khan
- ICON Epidemiology, ICON plc, Vancouver, BC V6B 1P1, Canada.
| | - Seth M Pollack
- Fred Hutchinson Cancer Research Center, University of Washington, Seattle, WA 98109, USA.
| | - Brian A Van Tine
- Division of Medical Oncology, Department of Medicine, Washington University School of Medicine, St Louis, MO 63110, USA.
- Siteman Cancer Center, St. Louis, MO 63110, USA.
| |
Collapse
|
27
|
Han I, Kim JH, Park H, Kim HS, Seo SW. Deep learning approach for survival prediction for patients with synovial sarcoma. Tumour Biol 2018; 40:1010428318799264. [PMID: 30261823 DOI: 10.1177/1010428318799264] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Synovial sarcoma is a rare disease with diverse progression characteristics. We developed a novel deep-learning-based prediction algorithm for survival rates of synovial sarcoma patients. The purpose of this study is to evaluate the performance of the proposed prediction model and demonstrate its clinical usage. The study involved 242 patients who were diagnosed with synovial sarcoma in three institutions between March 2001 and February 2013. The patients were randomly divided into a training set (80%) and a testing set (20%). Fivefold cross validation was performed utilizing the training set. The test set was retained for the final testing. A Cox proportional hazard model, simple neural network, and the proposed survival neural network were all trained utilizing the same training set, and fivefold cross validation was performed. The final testing was performed utilizing the isolated test data to determine the best prediction model. The multivariate Cox proportional hazard regression analysis revealed that size, initial metastasis, and margin were independent prognostic factors. In fivefold cross validation, the median value of the receiver-operating characteristic curve (area under the curve) was 0.87 in the survival neural network, which is significantly higher compared to the area under the curve of 0.792 for the simple neural network (p = 0.043). In the final test, survival neural network model showed the better performance (area under the curve: 0.814) compared to the Cox proportional hazard model (area under the curve: 0.629; p = 0.0001). The survival neural network model predicted survival of synovial sarcoma patients more accurately compared to Cox proportional hazard model.
Collapse
Affiliation(s)
- Ilkyu Han
- 1 Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - June Hyuk Kim
- 2 Orthopaedic Oncology Clinic, National Cancer Center, Goyang, Korea
| | - Heeseol Park
- 3 Department of Orthopaedic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea
| | - Han-Soo Kim
- 1 Department of Orthopaedic Surgery, Seoul National University Hospital, Seoul, Korea
| | - Sung Wook Seo
- 3 Department of Orthopaedic Surgery, Samsung Medical Center, School of Medicine, Sungkyunkwan University, Seoul, Korea.,4 Department of Health Sciences and Technology, Sungkyunkwan University, Seoul, Korea
| |
Collapse
|
28
|
Yang M, Zhong N, Zhao C, Xu W, He S, Zhao J, Yang X, Xiao J. Surgical management and outcome of synovial sarcoma in the spine. World J Surg Oncol 2018; 16:175. [PMID: 30149806 PMCID: PMC6112132 DOI: 10.1186/s12957-018-1471-x] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2018] [Accepted: 08/03/2018] [Indexed: 12/22/2022] Open
Abstract
Background Synovial sarcoma (SS) is a soft tissue sarcoma that rarely occurs in the spine, and a minimal number of cases have been reported in the literature. Spinal SS is challenging in diagnosis and treatment and has a poor prognosis. The aim of this study was to summarize and analyse the clinical features and outcomes of patients with spinal SS. Methods A total of 16 cases of patients with spinal SS admitted to our institution were reviewed retrospectively. General information, radiological findings and treatment strategies were collected. These patients were followed up regarding their continuing treatment, local or distant recurrence and survival. Results Spinal SS patients in this series ranged in age from 12 to 68 years (median, 33). Four en bloc resections and 12 piecemeal resections were performed. Improved Frankel (P = 0.002), visual analogue scale (P = 0.002) and Karnofsky Performance Status (P = 0.002) scores were seen postoperatively. The mean follow-up period was 35.9 ± 23.5 (median 31.5, range 4–87) months, with four local recurrences and three distant metastases detected. Eight patients (50.0%) died of disease by the last follow-up. The 1-, 3- and 5-year overall survival rates were 87.5%, 61.4% and 40.9%, respectively. Preoperative chemotherapy was used in three patients to facilitate surgical resection, and adjuvant chemotherapy and radiotherapy were used in six patients. Conclusions Spinal SS has a relatively high risk of local recurrence and distant metastasis. Surgical intervention can improve the neurological function and relieve pain in these patients. En bloc excision is an effective treatment strategy to improve survival and prevent local recurrence. Management of spinal SS should be under the instruction of a multidisciplinary team.
Collapse
Affiliation(s)
- Minglei Yang
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Nanzhe Zhong
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Chenglong Zhao
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Wei Xu
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Shaohui He
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Jian Zhao
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China
| | - Xinghai Yang
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
| | - Jianru Xiao
- Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical University, 415 Fengyang Road, Shanghai, 200003, China.
| |
Collapse
|
29
|
El Chediak A, Mukherji D, Temraz S, Nassif S, Sinno S, Mahfouz R, Shamseddine A. Primary synovial sarcoma of the kidney: a case report of complete pathological response at a Lebanese tertiary care center. BMC Urol 2018; 18:40. [PMID: 29751751 PMCID: PMC5948733 DOI: 10.1186/s12894-018-0358-z] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 05/03/2018] [Indexed: 12/17/2022] Open
Abstract
Background Primary synovial sarcoma of the kidney is a rare type of soft tissue sarcoma. Its presenting features can resemble those of other renal tumors; rendering its early diagnosis, a dilemma. Several cases of renal synovial sarcoma have been reported in the literature with varying treatment options and outcomes. This article describes a rare case of primary renal synovial sarcoma and reviews all cases in the literature. Case presentation A 26-year-old male presented with flank pain and hematuria. Initially diagnosed with Wilm’s tumor, revision of pathology and histology, along with the immunohistochemical profile, confirmed, nevertheless, the diagnosis of primary monophasic synovial sarcoma of the kidney with the SYT-SSX2 fusion transcript. Follow-up, post nephrectomy, revealed recurrence within the lungs and at the surgical bed. Surgical resection followed by adjuvant chemotherapy regimen constituting of Doxorubicin and Ifosfamide, achieved complete pathological response. Conclusion In this case report, we emphasize the need for accurate diagnosis and prompt treatment. We propose multimodality treatment approach including surgery along with anthracycline-based chemotherapy to induce complete remission.
Collapse
Affiliation(s)
- Alissar El Chediak
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut - Medical Center, P.o.Box: 11-0236, Riad El Solh, Beirut, 110 72020, Lebanon
| | - Deborah Mukherji
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut - Medical Center, P.o.Box: 11-0236, Riad El Solh, Beirut, 110 72020, Lebanon
| | - Sally Temraz
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut - Medical Center, P.o.Box: 11-0236, Riad El Solh, Beirut, 110 72020, Lebanon
| | - Samer Nassif
- Department of Pathology and Laboratory Medicine, American University of Beirut - Medical Center, Beirut, Lebanon
| | - Sara Sinno
- Department of Pathology and Laboratory Medicine, American University of Beirut - Medical Center, Beirut, Lebanon
| | - Rami Mahfouz
- Department of Pathology and Laboratory Medicine, American University of Beirut - Medical Center, Beirut, Lebanon
| | - Ali Shamseddine
- Department of Internal Medicine, Division of Hematology/Oncology, American University of Beirut - Medical Center, P.o.Box: 11-0236, Riad El Solh, Beirut, 110 72020, Lebanon.
| |
Collapse
|
30
|
Stacchiotti S, Van Tine BA. Synovial Sarcoma: Current Concepts and Future Perspectives. J Clin Oncol 2018; 36:180-187. [DOI: 10.1200/jco.2017.75.1941] [Citation(s) in RCA: 90] [Impact Index Per Article: 15.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Synovial sarcoma (SS) is a rare sarcoma driven by a translocation between SS18 and SSX 1, 2, or 4. With approximately 800 to 1,000 cases a year in the United States, it most commonly affects young adults between the ages of 15 and 30 years. The resultant tumors are either monophasic (pure sarcomas), biphasic (a combination or epithelioid and sarcomatous components), or poorly differentiated. The hybrid transcription factor SS18:SSX alters SWItch/Sucrose Non-Fermentable (SWI/SNF) chromatin remodeling and global methylation patterns that may allow for future therapeutic opportunities. In this review, we focus on the pharmacologic management of SS, both in the curative setting, where the standard approach is wide surgical excision combined with radiotherapy and/or (neo)adjuvant chemotherapy as appropriate, and in the palliative setting. In advanced disease, chemotherapy with anthracyclines and/or ifosfamide, trabectedin, or pazopanib has been demonstrated to be more active compared with other soft tissue sarcomas. In addition, a better understanding of the molecular and immunologic characteristics of SS has allowed for the identification of new potential targets and the development of novel biology-driven therapies that are all at different stages of testing. There include targeted agents, immunotherapy, and metabolic therapies. Because the impact of these strategies for improving SS outcome is still limited, current and future research is strongly needed to better understand the tumor biology, to identify predictive biomarkers, and to improve the outcomes for patients with SS.
Collapse
Affiliation(s)
- Silvia Stacchiotti
- Silvia Stacchiotti, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan, Italy; and Brian Andrew Van Tine, Washington University in St Louis, St Louis, MO
| | - Brian Andrew Van Tine
- Silvia Stacchiotti, Fondazione Istituto di Ricovero e Cura a Carattere Scientifico Istituto Nazionale Tumori, Milan, Italy; and Brian Andrew Van Tine, Washington University in St Louis, St Louis, MO
| |
Collapse
|
31
|
An extremely rare lung tumor of a young adult: Primary synovial sarcoma. TURK GOGUS KALP DAMAR CERRAHISI DERGISI-TURKISH JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2018; 26:157-160. [PMID: 32082727 DOI: 10.5606/tgkdc.dergisi.2018.13765] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/03/2016] [Accepted: 03/10/2017] [Indexed: 11/21/2022]
Abstract
Primary lung sarcoma is an extremely rare tumor accounting for less than 0.5% of all malignant lung tumors. Diagnosis is mostly established postoperatively. In this article, we present a 29-yearold male patient with a lobulated and well-marginated mass in the lower lobe of the right lung. A diagnosis of monophasic fibrous synovial sarcoma of the lung was established after right lower lobectomy. Resection margins were tumor-free. Postoperative positron-emission tomography/computed tomography did not show any other primary or metastatic focus. Despite the lack of a preoperative diagnosis, the advised treatment in such tumors is complete resection ensuring tumor-free surgical margins.
Collapse
|
32
|
Verbeek BM, Kaiser CL, Larque AB, Hornicek FJ, Raskin KA, Schwab JH, Chen YL, Lozano Calderón SA. Synovial sarcoma of the shoulder: A series of 14 cases. J Surg Oncol 2017; 117:788-796. [DOI: 10.1002/jso.24889] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2017] [Accepted: 09/27/2017] [Indexed: 12/29/2022]
Affiliation(s)
- Bianca M. Verbeek
- Department of Orthopaedic Surgery, Musculoskeletal Oncology Service; Massachusetts General Hospital-Harvard Medical School, Massachusetts General Hospital; Boston Massachusetts
| | - Courtney L. Kaiser
- Department of Orthopaedic Surgery, Musculoskeletal Oncology Service; Massachusetts General Hospital-Harvard Medical School, Massachusetts General Hospital; Boston Massachusetts
| | - Ana B. Larque
- Department of Orthopaedic Surgery, Musculoskeletal Oncology Service; Massachusetts General Hospital-Harvard Medical School, Massachusetts General Hospital; Boston Massachusetts
| | - Francis J. Hornicek
- Department of Orthopaedic Surgery, Musculoskeletal Oncology Service; Massachusetts General Hospital-Harvard Medical School, Massachusetts General Hospital; Boston Massachusetts
| | - Kevin A. Raskin
- Department of Orthopaedic Surgery, Musculoskeletal Oncology Service; Massachusetts General Hospital-Harvard Medical School, Massachusetts General Hospital; Boston Massachusetts
| | - Joseph H. Schwab
- Department of Orthopaedic Surgery, Musculoskeletal Oncology Service; Massachusetts General Hospital-Harvard Medical School, Massachusetts General Hospital; Boston Massachusetts
| | - Yen-Lin Chen
- Department of Orthopaedic Surgery, Musculoskeletal Oncology Service; Massachusetts General Hospital-Harvard Medical School, Massachusetts General Hospital; Boston Massachusetts
| | - Santiago A. Lozano Calderón
- Department of Orthopaedic Surgery, Musculoskeletal Oncology Service; Massachusetts General Hospital-Harvard Medical School, Massachusetts General Hospital; Boston Massachusetts
| |
Collapse
|
33
|
Abstract
BACKGROUND Soft tissue sarcomas are challenging to oncologists due to their unique character, the infrequency of their occurrence, and the difficulties in predicting outcomes. Advances in imaging, as well as improvements in surgical techniques and adjunctive treatment methods, have improved care for patients with these unusual disorders. METHODS The various types of soft tissue tumors are defined, and the statistics for the Orthopaedic Oncology Group in relation to them are reviewed and compared with literature references. RESULTS The overall survival rate for 1,220 tumors treated at our institute from June 1972 to June of 2001 was 72%, with a wide range. Patients with leiomyosarcomas, clear cell sarcomas, and malignant fibrous histiocytomas had a poorer survival rate, while those with fibrosarcomas, liposarcomas, and neurofibrosarcomas fared better. Outcome was affected by patient age, tumor anatomic site, tumor stage, and a history of recurrence. CONCLUSIONS Competent imaging, predictive immunological and genetic studies, improved surgery, and newer methods of adjunctive and neoadjunctive treatment should result in improvements in outcomes for patients with these tumors.
Collapse
|
34
|
Abstract
OBJECTIVES To analyze the treatment outcomes and the effects of adjuvant radiotherapy (RT) in patients with synovial sarcoma (SS). MATERIALS AND METHODS The medical records of 103 patients treated with definitive surgery for SS, with/without RT, from August 1982 to July 2013 were reviewed retrospectively. The median age of the patients was 33 years (range, 5 to 72 y). The most frequent tumor location was the extremities (79 patients, 77%). Seventy-five patients (73%) received adjuvant RT and 26 (25%) did not. The median dose of adjuvant RT was 61.2 Gy (range, 45 to 66.6 Gy). RESULTS The median follow-up period was 5.4 years (range, 0.2 to 31.0 y). The 5- and 10-year overall survival rates were 77 % and 65%, respectively. The progression-free survival (PFS) rates at 5 and 10 years were 52% and 43%, respectively. The most common site of initial failure was the lung (24 patients), followed by local recurrence (14 patients). The 5-year local-recurrence-free survival (LRFS) and distant-metastasis-free survival (DMFS) rates were 80% and 63%, respectively. On multivariate analysis, a mitosis count of <10 per 10 high-power fields (HPF) was a significant predictor of better overall survival, PFS, LRFS, and DMFS (P=0.004, <0.001, 0.025, and <0.001, respectively). Adjuvant RT was an additional prognostic factor for better PFS and LRFS (P=0.006 and 0.028, respectively). A positive/uncheckable resection margin was associated with poor prognosis for DMFS (P=0.011). There was no significant difference in LRFS between the higher and lower RT dose groups (<63 Gy group, 89%; ≥63 Gy group, 88%; P=0.772). CONCLUSIONS The lung and primary site were frequent sites of failure in patients treated with definitive surgery for SS. Adjuvant RT improved LRFS and PFS. Frequent mitotic figures (≥10 mitoses per 10 HPF) were the worst prognostic factor for these patients.
Collapse
|
35
|
Ng VY, Louie P, Punt S, Conrad EU. Malignant Transformation of Synovial Chondromatosis: A Systematic Review. Open Orthop J 2017; 11:517-524. [PMID: 28694891 PMCID: PMC5481616 DOI: 10.2174/1874325001711010517] [Citation(s) in RCA: 21] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2016] [Revised: 02/20/2017] [Accepted: 02/23/2017] [Indexed: 12/20/2022] Open
Abstract
Background: Synovial chondromatosis (SCh) can undergo malignant transformation. Pathologic diagnosis of secondary synovial chondrosarcoma (SChS) is challenging and misdiagnosis may result in over- or undertreatment. Method: A systematic review revealed 48 cases of SChS published in 27 reports since 1957. Data was collected to identify findings indicative of SChS and outcomes of treatment. Results: At median follow-up of 18 months, patients were reported as alive (10%), alive without disease (22%), alive with disease (15%), dead of disease (19%), dead of pulmonary embolism (4%), and unknown (29%). Initial diagnosis of SChS (grade: low/unknown 48%, intermediate/high 52%) was after biopsy in 58%, local resection in 29%, and amputation in 13%. Seventy-four percent of patients underwent 1.8 (mean) resections. Patients treated prior to 1992 were managed with amputation in 79% of cases compared to 48% after 1992. Symptoms were present for 72 mos prior to diagnosis of SChS. Synovial chondrosarcoma demonstrated symptom progression over several months (82%), rapid recurrence after complete resection (30%), and medullary canal invasion (43%). The SChS tumor dimensions were seldom quantified. Conclusion: Malignant degeneration of synovial chondromatosis is rare but can necessitate morbid surgery or result in death. Pathognomonic signs for SChS including intramedullary infiltration are present in the minority of cases. Progression of symptoms, quick local recurrence, and muscle infiltration are more suggestive of SChS. Periarticular cortical erosion, extra-capsular extension, and metaplastic chondroid features are non-specific. Although poorly documented for SChS, tumor size is a strong indicator of malignancy. Biopsy and partial resection are prone to diagnostic error. Surgical decisions are frequently based on size and clinical appearance and may be in conflict with pathologic diagnosis.
Collapse
Affiliation(s)
- Vincent Y Ng
- Department of Orthopaedics, Greenebaum Cancer Center, University of Maryland Medical Center, 110 S. Paca St., 6 Floor, Suite 300, Baltimore, MD 21201, USA
| | - Philip Louie
- Department of Orthopaedics, Rush University Medical Center, Chicago IL, USA
| | - Stephanie Punt
- Department of Orthopaedics, Rush University Medical Center, Chicago IL, USA
| | - Ernest U Conrad
- Department of Orthopedics and Sports Medicine, Seattle Children's Hospital, 4800 Sandpoint Way NE, Seattle, WA 98105, USA
| |
Collapse
|
36
|
Wu Y, Bi W, Han G, Jia J, Xu M. Influence of neoadjuvant chemotherapy on prognosis of patients with synovial sarcoma. World J Surg Oncol 2017; 15:101. [PMID: 28494784 PMCID: PMC5425994 DOI: 10.1186/s12957-017-1165-9] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2017] [Accepted: 04/23/2017] [Indexed: 01/27/2023] Open
Abstract
Background 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. Methods A 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). Results The 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. Conclusions Neoadjuvant 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.
Collapse
Affiliation(s)
- Yanan Wu
- Department of Bone Tumor, The General Hospital of the People's Liberation Army, Beijing, 100853, China
| | - Wenzhi Bi
- Department of Bone Tumor, The General Hospital of the People's Liberation Army, Beijing, 100853, China.
| | - Gang Han
- Department of Bone Tumor, The General Hospital of the People's Liberation Army, Beijing, 100853, China
| | - Jinpeng Jia
- Department of Bone Tumor, The General Hospital of the People's Liberation Army, Beijing, 100853, China
| | - Meng Xu
- Department of Bone Tumor, The General Hospital of the People's Liberation Army, Beijing, 100853, China
| |
Collapse
|
37
|
Lee K, Kang MC, Lee HW, Park JH, Baek HJ, Cho SJ, Jeon DG. Pulmonary Metastasectomy in Adult Patients with Synovial Sarcoma: A Single-Center Experience. THE KOREAN JOURNAL OF THORACIC AND CARDIOVASCULAR SURGERY 2016; 49:451-455. [PMID: 27965922 PMCID: PMC5147470 DOI: 10.5090/kjtcs.2016.49.6.451] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/12/2016] [Revised: 09/04/2016] [Accepted: 09/12/2016] [Indexed: 11/25/2022]
Abstract
Background This study assessed the efficacy of pulmonary metastasectomy for synovial sarcoma in adult patients. Methods Fifty patients, diagnosed with pulmonary metastasis from June 1990 to August 2010, were reviewed retrospectively. Twenty-eight patients underwent complete pulmonary metastasectomy, and their survival was evaluated. Age, sex, time to metastatic progression, laterality, number of tumors, size of largest nodule, and number of metastasectomies were analyzed as potential prognostic factors. Results In all, 29 patients underwent at least one pulmonary metastasectomy, and 51 resections were performed. One intraoperative mortality occurred, and the 5-year survival rate was 58.4%. Bilateral metastases and early metastatic progression were associated with poor survival in multivariate analyses. Conclusion Surgical resection can be a good option for treating pulmonary metastasis in patients with synovial sarcoma. Repeated resection was feasible with low mortality and morbidity.
Collapse
Affiliation(s)
- Kanghoon Lee
- Department of Thoracic and Cardiovascular Surgery, Asan Medical Center, University of Ulsan College of Medicine
| | - Moon Chul Kang
- Department of Thoracic and Cardiovascular Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences
| | - Hae Won Lee
- Department of Thoracic and Cardiovascular Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences
| | - Jong Ho Park
- Department of Thoracic and Cardiovascular Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences
| | - Hee Jong Baek
- Department of Thoracic and Cardiovascular Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences
| | - Sung Joon Cho
- Department of Thoracic and Cardiovascular Surgery, Kangwon National University School of Medicine
| | - Dae-Geun Jeon
- Department of Orthopaedic Surgery, Korea Cancer Center Hospital, Korea Institute of Radiological and Medical Sciences
| |
Collapse
|
38
|
Primary Mediastinal Synovial Sarcoma Presenting as Superior Vena Cava Syndrome: A Rare Case Report and Review of the Literature. Case Rep Oncol Med 2015; 2015:651813. [PMID: 26101678 PMCID: PMC4458531 DOI: 10.1155/2015/651813] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2014] [Revised: 01/21/2015] [Accepted: 02/15/2015] [Indexed: 01/31/2023] Open
Abstract
Primary mediastinal sarcomas are aggressive tumors with a very rare incidence. This report describes the case of a 35-year-old male patient who presented with acute symptoms of dyspnoea, facial puffiness, voice-hoarseness, and engorged neck veins. With the clinical picture consistent with the superior vena cava (SVC) syndrome, the patient was investigated with computed tomography of the chest. This revealed a large soft tissue density mass lesion compressing the SVC along with other critical superior mediastinal structures. Histopathological evaluation of the mass revealed features consistent with a soft tissue sarcoma and positive staining was observed for vimentin and S-100. Cytogenetic analysis by fluorescent in situ hybridisation (FISH) demonstrated the t(X:18) translocation. Thus diagnosis was established as primary mediastinal synovial sarcoma. Patient was treated with three cycles of neoadjuvant chemotherapy, to which there was a partial response as per the RECIST criteria. Surgical excision of the mediastinal mass was performed, and further postoperative treatment with adjuvant chemoradiotherapy was provided. Patient currently is free of disease. This is to the best of our knowledge the first report in the world literature of a successfully treated case of “primary mediastinal sarcomas presenting as SVC syndrome.” Patient is under regular surveillance at our clinic and remains free of recurrence one year after treatment completion.
Collapse
|
39
|
Arora S, Batra S, Rao S, Maini L, Gautam V. "A 40-year-old female with painless, slow growing prepatellar mass". J Clin Orthop Trauma 2014; 5:274-9. [PMID: 25983512 PMCID: PMC4263996 DOI: 10.1016/j.jcot.2014.09.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/30/2014] [Accepted: 09/03/2014] [Indexed: 01/27/2023] Open
Abstract
A 40-year-old woman from India presented with a mass in the front of her left knee which had been present for 8 months. Local examination revealed a globular mass of approximate size 5 cm × 4 cm × 4 cm in front of the lower pole of left patella. The patient was investigated with imaging studies and laboratory tests. Plain radiograph of the chest was normal. In addition, contrast enhanced Magnetic Resonance Imaging (MRI) of the left knee was performed. Based on the history, physical examination, laboratory and imaging studies, what is the differential diagnosis?
Collapse
Affiliation(s)
- Sumit Arora
- Department of Orthopaedic Surgery, The Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi 110002, India,Corresponding author. 2/2, Vijay Nagar, Delhi 110009, India. Tel.: +91 9868329389.
| | - Sahil Batra
- Department of Orthopaedics/ Spine Surgery, Indian Spinal Injury Center, Vasant Kunj, New Delhi 110070, India
| | - Seema Rao
- Department of Pathology, Sir Ganga Ram Hospital, New Delhi 110060, India
| | - Lalit Maini
- Department of Orthopaedic Surgery, The Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi 110002, India
| | - V.K. Gautam
- Department of Orthopaedic Surgery, The Maulana Azad Medical College & Associated Lok Nayak Hospital, New Delhi 110002, India
| |
Collapse
|
40
|
Baheti AD, Tirumani SH, Sewatkar R, Shinagare AB, Hornick JL, Ramaiya NH, Jagannathan JP. Imaging features of primary and metastatic extremity synovial sarcoma: a single institute experience of 78 patients. Br J Radiol 2014; 88:20140608. [PMID: 25431890 DOI: 10.1259/bjr.20140608] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
OBJECTIVE To study the appearance of primary and metastatic extremity synovial sarcoma (SS) on cross-sectional imaging. METHODS In this institutional review board-approved, Health Insurance Portability and Accountability Act-compliant retrospective study, the imaging features of 78 patients (42 males and 36 females; mean age, 40 years) with primary and metastatic extremity SS on MRI and multidetector CT were reviewed, with baseline MRI of the primary available in 31 patients. RESULTS Primary SSs were predominantly well-circumscribed (27/31) and heterogeneously enhancing solid (18/31) or solid-cystic (13/31) tumours. Imaging features visualized included the presence of perilesional oedema (14/31), interfascial (15/31) and intercompartmental extension (7/31), triple sign (11/31), intratumoral haemorrhage (10/31), calcification (6/31), bowl of grapes appearance (5/31) and bone involvement (3/31). Smaller T1 stage tumours (8/31) appeared as heterogeneously enhancing lesions, with some lesions demonstrating interfascial and intercompartmental extension and perilesional oedema. Recurrent/metastatic disease developed in 49/78 (63%) patients. Of these, 20/78 (26%) had metastasis at presentation, while the remaining developed metastatic disease at a median interval of 27 months (range, 3-161 months). Pleuropulmonary metastases (46/78) were the most common sites, with most of the metastases being pleural based. On univariate analysis, larger tumour size, the presence of perilesional oedema, intercompartmental extension, the presence of intralesional haemorrhage and bowl of grapes appearance on MRI were associated with a significantly higher incidence of metastatic disease. CONCLUSION Certain imaging features of primary SS predict the risk of development of metastatic disease. Imaging features of T1 stage tumours included heterogeneous enhancement, interfascial extension and perilesional oedema. Pleural-based metastases are commonly seen in SSs. ADVANCES IN KNOWLEDGE Imaging features of primary SS correlate with metastatic disease. Pleural-based metastases are often present in SSs.
Collapse
Affiliation(s)
- A D Baheti
- 1 Department of Imaging, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | | | | | | | | | | | | |
Collapse
|
41
|
The Role of (18)F-FDG PET/CT as a Prognostic Factor in Patients with Synovial Sarcoma. Nucl Med Mol Imaging 2014; 49:33-41. [PMID: 25774236 DOI: 10.1007/s13139-014-0301-5] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2014] [Revised: 09/14/2014] [Accepted: 09/26/2014] [Indexed: 01/27/2023] Open
Abstract
PURPOSE This research aims to investigate the potential of (18)F-fluorodeoxyglucose positron emission tomography/computed tomography (FDG PET) to predict pathologic response after neoadjuvant chemotherapy (NAC) and overall survival (OS) of patients with synovial sarcoma in Korea. METHODS Twenty patients with synovial sarcoma from January 2001 to December 2011 were reviewed retrospectively. All patients underwent pre-treatment FDG PET and tumor removal. Patients were classified with the maximum SUV (SUVmax), metabolic tumor volume (MTV), total lesion glycolysis (TLG), age, sex, histologic subtype, tumor size, NAC, resection margin, and metastasis at diagnosis. Pathologic response was assessed using the French Federation of Cancer Centers system. Statistical analyses were analyzed using the Kaplan-Meier method, log-rank test, Cox proportional hazards regression model, and Mann-Whitney test. RESULTS Nine patients (45 %) showed pathologic response, and ten patients survived. Higher SUVmax, higher MTV, higher TLG, monophasic epithelial type, and metastasis at diagnosis were significantly related to poorer OS (p = 0.047, 0.016, 0.016, 0.045, and 0.018, respectively). By multivariate analysis, metastasis at diagnosis was significantly related to poorer OS (p = 0.012/HR = 5.9, 95 % CI 1.47 to 24.1). The SUVmax, MTV, and TLG of the non-responder group were significantly higher than those of the responder group (p = 0.020, 0.020, and 0.020, respectively). There was no significant difference in size between the two groups (p = 0.062). CONCLUSIONS A higher SUVmax on the pre-treatment scan, monophasic epithelial type, and metastasis at diagnosis were significantly associated with a poorer OS, and pathologic responders showed a higher SUVmax before NAC. The PET parameters can be used to predict OS and pathologic response in patients with synovial sarcomas before NAC.
Collapse
|
42
|
Wushou A, Miao XC. Tumor size predicts prognosis of head and neck synovial cell sarcoma. Oncol Lett 2014; 9:381-386. [PMID: 25435996 PMCID: PMC4247063 DOI: 10.3892/ol.2014.2634] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2014] [Accepted: 09/26/2014] [Indexed: 12/20/2022] Open
Abstract
Head and neck synoviosarcoma (HNSS) is uncommon. To the best of our knowledge, the specific clinicopathological characteristics, treatment outcome and prognostic factors of HNSS were uninvestigated at the time of writing, so a meta-analysis was performed. An online data collection was carried out using PubMed and Google Scholar. Studies that reported primary HNSS and the treatment, follow-up time and outcome were chosen for the present study. In total, 93 cases from 26 studies were included for analysis. The study sample consisted of 55 males and 38 females and the median age was 32.1 years (range, 4-76 years). The median follow-up period was 62.1 months (range, 1-373 months). The tumor size was correlated with local recurrence and metastasis of HNSS, as well as with mortality (P=0.001, P<0.0001 and P<0.0001, respectively). The three-year, five-year and 10-year survival rates were 82.1, 80.4 and 78.2% for treatment with surgery alone, and 88.5, 85.5 and 82% for treatment with surgery plus radiotherapy, respectively. A significant tumor size-dependent difference was found between the overall survival (OS) rates (P<0.0001), as tumors that were >5.0 cm in diameter were associated with a worse OS rate (hazard ratio, 6.460; 95% confidence interval, 206-18.917; P=0.001). The tumor size was found to be an independent adverse prognostic factor for the OS of HNSS patients. In conclusion, surgical excision is a mainstream treatment of HNSS and post-operative adjuvant radiotherapy improves the OS rate of HNSS patients.
Collapse
Affiliation(s)
- Alimujiang Wushou
- Cancer Research Institute, Fudan University Shanghai Cancer Center; Department of Oncology, Shanghai Medical College, Fudan University, Shanghai 200032, P.R. China
| | - Xin-Chao Miao
- Department of Oral and Maxillofacial Surgery, Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai 200011, P.R. China
| |
Collapse
|
43
|
Pollack SM, Jones RL, Farrar EA, Lai IP, Lee SM, Cao J, Pillarisetty VG, Hoch BL, Gullett A, Bleakley M, Conrad EU, Eary JF, Shibuya KC, Warren EH, Carstens JN, Heimfeld S, Riddell SR, Yee C. Tetramer guided, cell sorter assisted production of clinical grade autologous NY-ESO-1 specific CD8(+) T cells. J Immunother Cancer 2014; 2:36. [PMID: 25317334 PMCID: PMC4196009 DOI: 10.1186/s40425-014-0036-y] [Citation(s) in RCA: 52] [Impact Index Per Article: 5.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2014] [Accepted: 09/09/2014] [Indexed: 12/31/2022] Open
Abstract
Background Adoptive T cell therapy represents an attractive modality for the treatment of patients with cancer. Peripheral blood mononuclear cells have been used as a source of antigen specific T cells but the very low frequency of T cells recognizing commonly expressed antigens such as NY-ESO-1 limit the applicability of this approach to other solid tumors. To overcome this, we tested a strategy combining IL-21 modulation during in vitro stimulation with first-in-class use of tetramer-guided cell sorting to generate NY-ESO-1 specific cytotoxic T lymphocytes (CTL). Methods CTL generation was evaluated in 6 patients with NY-ESO-1 positive sarcomas, under clinical manufacturing conditions and characterized for phenotypic and functional properties. Results Following in vitro stimulation, T cells stained with NY-ESO-1 tetramer were enriched from frequencies as low as 0.4% to >90% after single pass through a clinical grade sorter. NY-ESO-1 specific T cells were generated from all 6 patients. The final products expanded on average 1200-fold to a total of 36 billion cells, were oligoclonal and contained 67-97% CD8+, tetramer+ T cells with a memory phenotype that recognized endogenous NY-ESO-1. Conclusion This study represents the first series using tetramer-guided cell sorting to generate T cells for adoptive therapy. This approach, when used to target more broadly expressed tumor antigens such as WT-1 and additional Cancer-Testis antigens will enhance the scope and feasibility of adoptive T cell therapy. Electronic supplementary material The online version of this article (doi:10.1186/s40425-014-0036-y) contains supplementary material, which is available to authorized users.
Collapse
Affiliation(s)
- Seth M Pollack
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA ; Department of Medicine, University of Washington, Seattle, WA USA
| | - Robin L Jones
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA ; Department of Medicine, University of Washington, Seattle, WA USA
| | - Erik A Farrar
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA
| | - Ivy P Lai
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA ; Institute for Advanced Study, Technical University of Munich, Munich, Germany
| | - Sylvia M Lee
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA ; Department of Medicine, University of Washington, Seattle, WA USA
| | - Jianhong Cao
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA
| | - Venu G Pillarisetty
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA ; Department of Surgery, University of Washington, Seattle, WA USA
| | - Benjamin L Hoch
- Department of Pathology, University of Washington, Seattle, WA USA
| | - Ashley Gullett
- Department of Pathology, University of Washington, Seattle, WA USA
| | - Marie Bleakley
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA ; Department of Pediatrics, University of Washington, Seattle, WA USA
| | - Ernest U Conrad
- Department of Orthopedics, University of Washington, Seattle, WA USA
| | - Janet F Eary
- Department of Radiology, University of Alabama, Birmingham, AL USA
| | - Kendall C Shibuya
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA
| | - Edus H Warren
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA ; Department of Medicine, University of Washington, Seattle, WA USA
| | - Jason N Carstens
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA
| | - Shelly Heimfeld
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA
| | - Stanley R Riddell
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA ; Department of Medicine, University of Washington, Seattle, WA USA ; Institute for Advanced Study, Technical University of Munich, Munich, Germany
| | - Cassian Yee
- Clinical Research Division, D3-100 Fred Hutchinson Cancer Research Center, 1100 Fairview Ave, Seattle, WA 98109 USA ; Department of Medicine, University of Washington, Seattle, WA USA ; Department of Melanoma Medical Oncology, UT MD Anderson Cancer Center, 7455 Fannin St, Unit 904, Houston, TX 77054 USA
| |
Collapse
|
44
|
Thway K, Fisher C. Synovial sarcoma: defining features and diagnostic evolution. Ann Diagn Pathol 2014; 18:369-80. [PMID: 25438927 DOI: 10.1016/j.anndiagpath.2014.09.002] [Citation(s) in RCA: 186] [Impact Index Per Article: 18.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2014] [Accepted: 09/15/2014] [Indexed: 02/06/2023]
Abstract
Synovial sarcoma (SS) is a malignant mesenchymal neoplasm with variable epithelial differentiation, with a propensity to occur in young adults and which can arise at almost any site. It is generally viewed and treated as a high-grade sarcoma. As one of the first sarcomas to be defined by the presence of a specific chromosomal translocation leading to the production of the SS18-SSX fusion oncogene, it is perhaps the archetypal "translocation-associated sarcoma," and its translocation remains unique to this tumor type. Synovial sarcoma has a variety of morphologic patterns, but its chief forms are the classic biphasic pattern, of glandular or solid epithelial structures with monomorphic spindle cells and the monophasic pattern, of fascicles of spindle cells with only immunohistochemical or ultrastructural evidence of epithelial differentiation. However, there is significant morphologic heterogeneity and overlap with a variety of other neoplasms, which can cause diagnostic challenge, particularly as the immunoprofile is varied, SS18-SSX is not detected in 100% of SSs, and they may occur at unusual sites. Correct diagnosis is clinically important, due to the relative chemosensitivity of SS in relation to other sarcomas, for prognostication and because of the potential for treatment with specific targeted therapies in the near future. We review SS, with emphasis on the diagnostic spectrum, recent immunohistochemical and genetic findings, and the differential diagnosis.
Collapse
Affiliation(s)
- Khin Thway
- Sarcoma Unit, Royal Marsden Hospital, London UK.
| | | |
Collapse
|
45
|
Naing KW, Monjazeb AM, Li CS, Lee LY, Yang A, Borys D, Canter RJ. Perioperative radiotherapy is associated with improved survival among patients with synovial sarcoma: A SEER analysis. J Surg Oncol 2014; 111:158-64. [PMID: 25176165 DOI: 10.1002/jso.23780] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2014] [Accepted: 08/05/2014] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND METHODS We examined the outcomes of synovial sarcoma (SS) patients in a national database. We identified 1,189 patients from the Surveillance, Epidemiology, and End Results (SEER) database with data on site and extent of surgery. We excluded patients diagnosed before 1990, <18 years, or lacking pathologic confirmation. Using Kaplan-Meier and Cox proportional hazards analyses, we determined predictors of overall (OS) and disease-specific survival (DSS). RESULTS The mean age was 41, 49.3% were female, and 82.2% were white. Radiotherapy (RT) was administered to 57.5%. On multivariable analysis, age at diagnosis, sex, race, anatomic site, SEER summary stage, tumor size, surgery type, and RT predicted OS. Similar predictors of DSS were identified. The hazard ratio (HR) for OS was 0.65 (95% CI 0.48-0.88) in favor of RT and 0.62 (95% CI 0.45-0.86) for DSS. Five-year OS improved 8.4 ± 1.0% with RT (P=0.003), and five-year DSS improved 7.7 ± 1.0% with RT (P=0.015). CONCLUSIONS In the largest study to date examining the role of RT in synovial sarcoma, we observed that RT was associated with a statistically significant improvement in oncologic outcome among SS patients. These data support the use of RT in the multi-modality treatment of patients with SS.
Collapse
Affiliation(s)
- Khatija W Naing
- Division of Surgical Oncology, Department of Surgery, Davis Medical Center, University of California, Sacramento, California
| | | | | | | | | | | | | |
Collapse
|
46
|
Yaser S, Salah S, Al-Shatti M, Abu-Sheikha A, Shehadeh A, Sultan I, Salem A, Sughayer M, Al-Loh S, Al-Mousa A. Prognostic factors that govern localized synovial sarcoma: a single institution retrospective study on 51 patients. MEDICAL ONCOLOGY (NORTHWOOD, LONDON, ENGLAND) 2014. [PMID: 24770952 DOI: 10.1007/s12032-014-0958-8.] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
Synovial sarcoma is a rare type of sarcoma with poor prognosis. Data on relevant prognostic factors are inconsistent. The objective of this study was to determine the independent prognostic factors that govern local recurrence, distant metastasis and overall survival. A retrospective analysis of 51 patients treated for localized synovial sarcoma at a single institution by a multidisciplinary/multimodality approach over a period of 12 years. Patients, tumor and treatment characteristics were collected including age, sex, tumor site, location, depth, size, status of margins, histology subtype and involvement of bone or lymph nodes. Type of surgery, adjuvant chemotherapy and radiotherapy were also examined. The endpoints analyzed were local recurrence-free survival (LRFS), metastasis-free survival (MFS) and overall survival (OS). Median age of patients was 26 years (range 3-64 years) with 73 % above the age of 20 year. All patients received surgery, 57 % received adjuvant radiotherapy and 45 % adjuvant chemotherapy. The median survival was 111 months, and 5-year OS was 73 %. Deep seatedness of the tumor was linked to OS as the only independent risk factor. Twelve patients had local recurrence, and the 5-year LRFS was 61 %. Multivariate analysis determined negative margins and adjuvant radiotherapy as independent predicting factors for LRFS. Five-year MFS was 48 %; multivariate analysis identified monophasic subtype and site other than lower extremity as the only independent factors associated with inferior MFS. The most important factors that govern LRFS and MFS are negative margins and adjuvant radiotherapy for LRFS and tumor histology and site for MFS, while deep seatedness of the tumor is the sole independent factor that governs OS.
Collapse
Affiliation(s)
- Sameer Yaser
- Department of Medical Oncology, King Hussein Cancer Center, Al-Jubeiha, Amman, 11941, Jordan,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
47
|
Yaser S, Salah S, Al-Shatti M, Abu-Sheikha A, Shehadeh A, Sultan I, Salem A, Sughayer M, Al-Loh S, Al-Mousa A. Prognostic factors that govern localized synovial sarcoma: a single institution retrospective study on 51 patients. Med Oncol 2014; 31:958. [PMID: 24770952 DOI: 10.1007/s12032-014-0958-8] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2014] [Accepted: 04/01/2014] [Indexed: 10/25/2022]
Affiliation(s)
- Sameer Yaser
- Department of Medical Oncology, King Hussein Cancer Center, Al-Jubeiha, Amman, 11941, Jordan,
| | | | | | | | | | | | | | | | | | | |
Collapse
|
48
|
Crowson MG, Lalich I, Keeney MG, Garcia JJ, Price DL. Clinicopathologic factors and adjuvant treatment effects on survival in adult head and neck synovial cell sarcoma. Head Neck 2014; 37:375-80. [DOI: 10.1002/hed.23605] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2013] [Revised: 11/02/2013] [Accepted: 01/08/2014] [Indexed: 11/08/2022] Open
Affiliation(s)
| | - Ian Lalich
- Department of Otorhinolaryngology - Head and Neck Surgery; The Mayo Clinic; Rochester Minnesota
| | - Michael G. Keeney
- Department of Laboratory Medicine and Pathology; The Mayo Clinic; Rochester Minnesota
| | - Joaquin J. Garcia
- Department of Laboratory Medicine and Pathology; The Mayo Clinic; Rochester Minnesota
| | - Daniel L. Price
- Department of Otorhinolaryngology - Head and Neck Surgery; The Mayo Clinic; Rochester Minnesota
| |
Collapse
|
49
|
Primary synovial sarcomas of the mediastinum: a systematic review and pooled analysis of the published literature. ISRN ONCOLOGY 2014; 2014:412527. [PMID: 24563786 PMCID: PMC3916017 DOI: 10.1155/2014/412527] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/24/2013] [Accepted: 11/10/2013] [Indexed: 12/12/2022]
Abstract
Background. The aim of this systematic review is to attempt to provide a descriptive analysis for cases of synovial sarcoma (SS) arising in the mediastinum and to analyze prognostic factors. Methods. We performed PubMed database search in July 2013. Twenty-two studies, which included 40 patients, form the basis of this review. Demographic and disease-related factors were analyzed for possible influence on survival. Findings were compared with extremity SS studies reported in literature. Results. Sixteen cases (40%) presented with locally advanced unresectable disease, 2 (5%) with metastatic disease, and 22 (55%) with localized resectable disease. Median tumor size was 11 cm (range: 5–20 cm). Thirty patients were assessable for survival and had a 5-year OS of 36%. Completeness of resection was the only factor associated with significant improvement in OS (5-year survival of 63% and 0% in favor of complete resection, P = 0.003). Conclusion. Mediastinal SS is associated with poor prognosis as more cases are diagnosed at an advanced stage and with larger tumor size compared to extremity SS. Complete surgical resection is the only identified factor associated with better prognosis and may result in survival outcomes that are comparable with those for localized SS of the extremity.
Collapse
|
50
|
Paulino AC. Treatment options for children with nonrhabdomyosarcoma soft tissue sarcoma. Expert Rev Anticancer Ther 2014; 4:247-56. [PMID: 15056055 DOI: 10.1586/14737140.4.2.247] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
Nonrhabdomyosarcoma soft tissue sarcomas account for approximately 40% of all soft tissue sarcomas in children. Although these tumors are typically grouped together, individual tumor types with different biological characteristics have been found that may impact on the optimal therapy for each type of sarcoma in the future. Most of the current information regarding this tumor comes from the adult literature. Wide local excision appears to provide the best chance of cure. Future studies are needed to determine which adjuvant therapies are most useful in improving local control and overall survival in the different subsets of patients.
Collapse
Affiliation(s)
- Arnold C Paulino
- Department of Radiation Oncology, Emory Clinic, 1365 Clifton Road, NE, A1300, Atlanta, GA 30322, USA.
| |
Collapse
|