Long-Term Outcomes for Synovial Sarcoma Treated With Conservation Surgery and Radiotherapy

Journal Article · Thu Nov 15 04:00:00 EST 2007 · International Journal of Radiation Oncology, Biology and Physics

DOI:https://doi.org/10.1016/j.ijrobp.2007.04.056· OSTI ID:21039631

Zagars, Gunar K; Ballo, Matthew T ^[1]; Patel, Shreyaskumar R ^[2]; Lewis, Valerae O ^[3]; Pisters, Peter W.T. ^[4]; Benjamin, Robert S ^[2]; Pollock, Raphael E ^[4]

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1. Division of Radiation Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
2. Department of Sarcoma Medical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
3. Department of Orthopedic Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)
4. Department of Surgical Oncology, University of Texas M. D. Anderson Cancer Center, Houston, TX (United States)

Purpose: To evaluate prognostic factors and treatment outcomes in patients with localized synovial sarcoma treated with conservation surgery and radiotherapy (RT). Methods and Materials: Between 1960 and 2003, 150 patients with nonmetastatic synovial sarcoma were treated with conservation surgery and RT. The majority of patients (81%) were aged >20 years. Sixty-eight percent received postoperative RT, and 32% received preoperative RT. Forty-eight percent received adjuvant chemotherapy. Results: Median follow-up was 13.2 years. Overall survival (OS) rates at 5, 10, and 15 years were 76%, 57%, and 51%, respectively. Corresponding disease-free survival (DFS) rates were 59%, 52%, and 52%, respectively. Tumor size >5 cm predicted worse OS, DFS, disease-specific survival (DSS), and higher rate of distant metastases (DM). Age >20 years predicted worse DFS and DSS but not OS. Local control (LC) was 82% at 10 years. Positive or unknown resection margins predicted inferior LC rates. Forty-four percent developed DM by 10 years. Only 1% developed nodal metastases. Analysis of outcomes by treatment decade showed no significant differences with respect to LC and DM rates. Conclusions: Synovial sarcoma is adequately controlled at the primary site by conservation surgery and RT. Elective nodal irradiation is not indicated. Rates of development of DM and subsequent death from disease remain high, with no significant improvement in outcomes for this disease in the past four decades.

• OSTI ID: 21039631
• Journal Information: International Journal of Radiation Oncology, Biology and Physics, Journal Name: International Journal of Radiation Oncology, Biology and Physics Journal Issue: 4 Vol. 69; ISSN IOBPD3; ISSN 0360-3016
• Country of Publication: United States
• Language: English

Related Subjects

62 RADIOLOGY AND NUCLEAR MEDICINE
CHEMOTHERAPY
DEATH
IRRADIATION
METASTASES
PATIENTS
RADIOTHERAPY
SARCOMAS
SURGERY