Surgical excision and not chemotherapy is the most powerful modality in treating synovial sarcoma: the UK's North East experience
Surgical excision and not chemotherapy is the most powerful modality in treating synovial sarcoma: the UK's North East experience
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DOI：
10.1007/s00402-018-3059-x
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发表时间：
2019-04-01
影响因子：
2.3
通讯作者：
Gerrand, Craig
中科院分区：
文献类型：
--
作者：
Khan, Munir;Rankin, Kenneth S.;Gerrand, Craig
背景和目的我们回顾了我们的经验，滑膜肉瘤，以确定预测局部复发和总生存率的因素，化疗的影响和手术切除后的结果单独的Materials and Methods 81例患者在1997年和2014年之间接受治疗，平均年龄39岁（8-78）。肿瘤位于四肢55例（67%）。9例患者出现转移，10例患者出现不可切除的疾病。平均随访3.7年（SD 3.8）。治疗组姑息，手术，手术和放疗，或手术化疗（有或无放疗）。结果局部无复发生存率（LRFS）为73%，在5年，68%，10年和15年。在多变量分析中，手术切缘阳性是LRFS的独立预测因素。所有患者的5年总生存率（OS）为50%，而那些接受根治性治疗的患者的5年总生存率（OS）为62%。较大的肿瘤尺寸和非肢体位置是OS较差的预测因素。接受化疗的患者的OS或LRS并不比其他患者明显更好。解释这些结果表明，在可行的情况下，不应因化疗而推迟治愈性切除。虽然我们的系列研究很小，但只有在选定的四肢肿瘤较小的患者中，手术治疗才能获得良好的结局。
Background and purposeWe 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 methods81 patients were treated between 1997 and 2014 of mean age 39years (8-78). Tumours were in the extremity in 55 (67%). 9 patients presented with metastases and 10 with unresectable disease. Mean follow-up was 3.7years (SD 3.8). Treatment groups were palliative, surgery only, surgery and radiotherapy, or surgery with chemotherapy (with or without radiotherapy).ResultsLocal recurrence-free survival (LRFS) was 73% at 5years, and 68% at 10 and 15years. In multivariate analysis, positive surgical margins were an independent predictor of LRFS. Overall survival (OS) was 50% at 5years for all patients, and 62% at 5years 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.InterpretationThese 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.