Clinical Significance and Risk Factors of Local Recurrence in Synovial Sarcoma: A Retrospective Analysis of 171 Cases

Overview

Journal Front Surg

Specialty General Surgery

Date 2022 Jan 31

PMID 35096956

Authors

Hongqiang Zhang

Wending Huang

Qi Feng

Wei Sun

Wangjun Yan

Chunmeng Wang

Jianing Zhang

Kai Huang

Lin Yu

Xinglong Qu

Yong Chen

Affiliations

Soon will be listed here.

Abstract

To investigate risk factors of local recurrence of synovial sarcoma and the impact of local recurrence on survival. We retrospectively reviewed clinical data of patients with II to IIIB (AJCC8) synovial sarcoma who underwent surgery at our center between March 2005 and December 2016. Data relating clinicopathological factors, treatment and prognosis were collected. The impact of local recurrence on overall survival (OS), local recurrence-free survival (LRFS), and distant relapse-free survival (DRFS) were analyzed. The prognostic factors associated with local recurrence were also analyzed using Kaplan-Meier Curves and Cox regression analysis. A total of 171 patients were included in this analysis. After a median follow-up of 48 months, 66 patients (38.6%) experienced local recurrence. The 5-year OS, LRFS, and DRFS rates of patients with local recurrence were 37.6, 6.1, and 24.1%, respectively. Multivariate analysis showed that larger initial tumors, multiple recurrences, positive resection margins, marginal resection, and lack of adjuvant therapy were associated with higher local recurrence. Local recurrence of synovial sarcoma is associated with distant metastasis and poor survival. Chemoradiation improves the prognosis of patients with local recurrence, in particular those for which recurrence occurs shortly after initial treatment.

Citing Articles

Outcome of Soft Tissue Popliteal Sarcomas: 15 Years of Experience.

Tepedelenlioglu H, Tolunay T, Orhan O, Arikan S, Akgun E, Togral G Indian J Orthop. 2024; 59(1):34-39.

PMID: 39735885 PMC: 11680513. DOI: 10.1007/s43465-024-01263-8.

Primary pulmonary monophasic synovial sarcoma initially presenting with bloody pleural effusion: A case report and literature review.

Yin T, Liu B, Xue J, Liu X, Shang S, Wang Y Clin Case Rep. 2024; 12(5):e8841.

PMID: 38681033 PMC: 11053246. DOI: 10.1002/ccr3.8841.

Case report: Characteristics and nature of primary cardiac synovial sarcoma.

Kawasaki T, Nakajima T, Torigoe T, Onohara K, Ishii K, Kanno S Front Oncol. 2024; 14:1361414.

PMID: 38634047 PMC: 11022687. DOI: 10.3389/fonc.2024.1361414.

Sarcoma Immunotherapy: Confronting Present Hurdles and Unveiling Upcoming Opportunities.

Jeong S, Afroz S, Kang D, Noh J, Suh J, Kim J Mol Cells. 2023; 46(10):579-588.

PMID: 37853684 PMC: 10590708. DOI: 10.14348/molcells.2023.0079.

Multidisciplinary management of recurrent synovial sarcoma of the chest wall.

Endara S, De la Torre J, Teran F, Alarcon J, Tovar C N Am Spine Soc J. 2023; 15:100243.

PMID: 37575880 PMC: 10415753. DOI: 10.1016/j.xnsj.2023.100243.

References

Krieg A, Hefti F, Speth B, Jundt G, Guillou L, Exner U . Synovial sarcomas usually metastasize after >5 years: a multicenter retrospective analysis with minimum follow-up of 10 years for survivors. Ann Oncol. 2010; 22(2):458-67. DOI: 10.1093/annonc/mdq394. View

Chen Y, Yang Y, Wang C, Shi Y . Adjuvant chemotherapy decreases and postpones distant metastasis in extremity stage IIB/III synovial sarcoma patients. J Surg Oncol. 2012; 106(2):162-8. DOI: 10.1002/jso.23061. View

Italiano A, Penel N, Robin Y, Bui B, Le Cesne A, Piperno-Neumann S . Neo/adjuvant chemotherapy does not improve outcome in resected primary synovial sarcoma: a study of the French Sarcoma Group. Ann Oncol. 2008; 20(3):425-30. DOI: 10.1093/annonc/mdn678. View

ODonnell P, Griffin A, Eward W, Sternheim A, Catton C, Chung P . The effect of the setting of a positive surgical margin in soft tissue sarcoma. Cancer. 2014; 120(18):2866-75. DOI: 10.1002/cncr.28793. View

Canter R, Qin L, Maki R, Brennan M, Ladanyi M, Singer S . A synovial sarcoma-specific preoperative nomogram supports a survival benefit to ifosfamide-based chemotherapy and improves risk stratification for patients. Clin Cancer Res. 2008; 14(24):8191-7. PMC: 2779709. DOI: 10.1158/1078-0432.CCR-08-0843. View

Clark J, Rocques P, Crew A, Gill S, Shipley J, Chan A . Identification of novel genes, SYT and SSX, involved in the t(X;18)(p11.2;q11.2) translocation found in human synovial sarcoma. Nat Genet. 1994; 7(4):502-8. DOI: 10.1038/ng0894-502. View

ten Heuvel S, Hoekstra H, Bastiaannet E, Suurmeijer A . The classic prognostic factors tumor stage, tumor size, and tumor grade are the strongest predictors of outcome in synovial sarcoma: no role for SSX fusion type or ezrin expression. Appl Immunohistochem Mol Morphol. 2008; 17(3):189-95. DOI: 10.1097/PAI.0b013e31818a6f5c. View

Lewis J, Antonescu C, Leung D, Blumberg D, Healey J, Woodruff J . Synovial sarcoma: a multivariate analysis of prognostic factors in 112 patients with primary localized tumors of the extremity. J Clin Oncol. 2000; 18(10):2087-94. DOI: 10.1200/JCO.2000.18.10.2087. View

von Mehren M, Randall R, Benjamin R, Boles S, Bui M, Ganjoo K . Soft Tissue Sarcoma, Version 2.2018, NCCN Clinical Practice Guidelines in Oncology. J Natl Compr Canc Netw. 2018; 16(5):536-563. DOI: 10.6004/jnccn.2018.0025. View

10.

Gronchi A, Ferrari S, Quagliuolo V, Broto J, Lopez Pousa A, Grignani G . Histotype-tailored neoadjuvant chemotherapy versus standard chemotherapy in patients with high-risk soft-tissue sarcomas (ISG-STS 1001): an international, open-label, randomised, controlled, phase 3, multicentre trial. Lancet Oncol. 2017; 18(6):812-822. DOI: 10.1016/S1470-2045(17)30334-0. View

11.

Palmerini E, Staals E, Alberghini M, Zanella L, Ferrari C, Benassi M . Synovial sarcoma: retrospective analysis of 250 patients treated at a single institution. Cancer. 2009; 115(13):2988-98. DOI: 10.1002/cncr.24370. View

12.

Pisters P, Pollock R, Lewis V, Yasko A, Cormier J, Respondek P . Long-term results of prospective trial of surgery alone with selective use of radiation for patients with T1 extremity and trunk soft tissue sarcomas. Ann Surg. 2007; 246(4):675-81. DOI: 10.1097/SLA.0b013e318155a9ae. View

13.

Deshmukh R, Mankin H, Singer S . Synovial sarcoma: the importance of size and location for survival. Clin Orthop Relat Res. 2004; (419):155-61. View

14.

Bergh P, Meis-Kindblom J, Gherlinzoni F, Berlin O, Bacchini P, Bertoni F . Synovial sarcoma: identification of low and high risk groups. Cancer. 1999; 85(12):2596-607. DOI: 10.1002/(sici)1097-0142(19990615)85:12<2596::aid-cncr16>3.0.co;2-k. View

15.

Wisanuyotin T, Radapat K, Sirichativapee W, Paholpak P, Kosuwon W, Sumnanoont C . Prognostic factors and clinical outcomes in synovial sarcoma of the extremities. Asia Pac J Clin Oncol. 2012; 9(1):80-5. DOI: 10.1111/j.1743-7563.2012.01563.x. View

16.

Naing K, Monjazeb A, Li C, Lee L, Yang A, Borys D . Perioperative radiotherapy is associated with improved survival among patients with synovial sarcoma: A SEER analysis. J Surg Oncol. 2014; 111(2):158-64. PMC: 4305005. DOI: 10.1002/jso.23780. View

17.

Trovik C . Local recurrence of soft tissue sarcoma. A Scandinavian Sarcoma Group Project. Acta Orthop Scand Suppl. 2001; 72(300):1-31. View

18.

Brennan B, Stiller C, Grimer R, Dennis N, Broggio J, Francis M . Outcome and the effect of age and socioeconomic status in 1318 patients with synovial sarcoma in the English National Cancer Registry: 1985-2009. Clin Sarcoma Res. 2016; 6:18. PMC: 5070226. DOI: 10.1186/s13569-016-0058-y. View

19.

Luo Z, Zhang X, Peng W, Wu X, Wang H, Yu H . A Phase II Study of Gemcitabine, Vincristine, and Cisplatin As Second-Line Treatment for Patients with Advanced Soft Tissue Sarcoma. Medicine (Baltimore). 2015; 94(43):e1777. PMC: 4985388. DOI: 10.1097/MD.0000000000001777. View

20.

Crew A, Clark J, Fisher C, Gill S, Grimer R, CHAND A . Fusion of SYT to two genes, SSX1 and SSX2, encoding proteins with homology to the Kruppel-associated box in human synovial sarcoma. EMBO J. 1995; 14(10):2333-40. PMC: 398342. DOI: 10.1002/j.1460-2075.1995.tb07228.x. View