Chemotherapy is associated with improved survival in adult patients with primary extremity synovial sarcoma
Chemotherapy is associated with improved survival in adult patients with primary extremity synovial sarcoma
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DOI：
10.1097/01.sla.0000262787.88639.2b
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发表时间：
2007-07-01
影响因子：
9
通讯作者：
Singer, Samuel
中科院分区：
文献类型：
--
作者：
Eilber, Fritz C.;Brennan, Murray F.;Singer, Samuel
目的：确定以异环磷酰胺为基础的化疗（if）是否能提高原发性四肢滑膜肉瘤成年患者的生存率。患者和方法：前瞻性收集来自2家机构的患者资料，筛选1990 - 2002年间所有接受手术治愈的>= 5 cm、深部、原发性、四肢滑膜肉瘤成年患者（>= 16岁）。共有101例患者被确定，幸存者的中位随访时间为58个月。临床、病理和治疗变量分析疾病特异性生存（DSS）、远端无复发生存（DRFS）和局部无复发生存（LRFS）。结果：68例（67%）患者接受了IF治疗，33例（33%）患者原发肿瘤未接受化疗（NoC）。if治疗患者的特征[中位肿瘤大小= 7.2 cm，单相n = 46(68%)]与NoC患者相似[中位肿瘤大小= 7 cm；单相n = 23(70%)]。if组4年DSS为88%，NoC组为67% （P = 0.01）。与NoC相比，较小的尺寸（HR = 0.3 / 5cm, P < 0.0001）和IF治疗（HR = 0.3）。P = 0.007)与改善的DSS独立相关。IF治疗与改善DRFS独立相关（HR = 0.4, P = 0.03），但与改善LRFS无关（P = 0.39）。结论：以异环磷酰胺为基础的化疗可改善成人高危、原发性、四肢滑膜肉瘤患者的DSS，在此类患者的治疗中应予以考虑。
Purpose: To determine if ifosfamide-based chemotherapy (IF) offers a survival benefit to adult patients with primary extremity synovial sarcoma.Patients and Methods: Prospectively collected patient data from 2 institutions was used to identify all adult patients ( >= 16 years) with >= 5 cm, deep, primary, extremity, synovial sarcoma that underwent surgical treatment of cure from 1990 to 2002. A total of 10 1 patients were identified and the median follow-up for survivors was 58 months. Clinical, pathologic, and treatment variables were analyzed for disease-specific survival (DSS), distant recurrence-free survival (DRFS), and local recurrence-free survival (LRFS).Results: Sixty-eight (67%) patients were treated with IF and 33 (33%) patients received no chemotherapy (NoC) for the primary tumor. The characteristics of the IF-treated patients [median tumor size = 7.2 cm, monophasic n = 46 (68%)] were similar to NoC patients [median tumor size = 7 cm; monophasic n = 23 (70%)]. The 4-year DSS of the IF-treated patients was 88% compared with 67% for the NoC patients (P = 0.01). Smaller size (HR = 0.3 per 5-cm decrease, P < 0.0001) and treatment with IF (HR = 0.3 compared with NoC. P = 0.007) were independently associated with an improved DSS. Treatment with IF was independently associated with an improved DRFS (HR = 0.4, P = 0.03) but not associated with an improved LRFS (P = 0.39).Conclusion: Ifosfamide-based chemotherapy was associated with an improved DSS in adult patients with high-risk, primary, extremity, synovial sarcoma and should be considered in the treatment of such patients.