Clinical Features, Treatment, and Outcome in 102 Adult and Pediatric Patients with Localized High-Grade Synovial Sarcoma
H. Al-Hussaini,
D. Hogg,
M. E. Blackstein,
B. O'Sullivan,
C. N. Catton,
P. W. Chung,
A. M. Griffin,
D. Hodgson,
S. Hopyan,
R. Kandel,
P. C. Ferguson,
J. S. Wunder,
A. A. Gupta
Affiliations
H. Al-Hussaini
Division of Medical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, M5G 2M9, Canada
D. Hogg
Division of Medical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, M5G 2M9, Canada
M. E. Blackstein
Division of Medical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, M5G 2M9, Canada
B. O'Sullivan
Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, M5G 2M9, Canada
C. N. Catton
Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, M5G 2M9, Canada
P. W. Chung
Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, M5G 2M9, Canada
A. M. Griffin
University Musculoskeletal Oncology Unit, Division of Orthopaedic Surgery, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, M5G 1Z5, Canada
D. Hodgson
Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, M5G 2M9, Canada
S. Hopyan
Department of Orthopedic Surgery, Hospital for Sick Children, University of Toronto, Toronto, ON, M5G 1X8, Canada
R. Kandel
Department of Pathology, Mount Sinai Hospital, Toronto, ON, M5G 1Z5, Canada
P. C. Ferguson
University Musculoskeletal Oncology Unit, Division of Orthopaedic Surgery, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, M5G 1Z5, Canada
J. S. Wunder
University Musculoskeletal Oncology Unit, Division of Orthopaedic Surgery, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, M5G 1Z5, Canada
A. A. Gupta
Division of Medical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, M5G 2M9, Canada
Background. There remains controversy on the routine use of chemotherapy in localized SS. Methods. The records of 87 adult (AP) and 15 pediatric (PP) patients with localized SS diagnosed between 1986 and 2007 at 2 centres in Toronto were reviewed. Results. Median age for AP and PP was 37.6 (range 15–76) and 14 (range 0.4–18) years, respectively. 65 (64%) patients had large tumours (>5 cm). All patients underwent en bloc surgical resection resulting in 94 (92.2%) negative and 8 (7.8%) microscopically positive surgical margins. 72 (82.8%) AP and 8 (53%) PP received radiotherapy. Chemotherapy was administered to 12 (13.8%) AP and 13 (87%) PP. 10 AP and 5 PP were evaluable for response to neoadjuvant chemotherapy, with response rate of 10% and 40%, respectively. 5-year EFS and OS was 69.3±4.8% and 80.3±4.3%, respectively, and was similar for AP and PP, In patients with tumors >5 cm, in whom chemotherapy might be considered most appropriate, relapse occurred in 9/19 (47%) with chemotherapy, compared to 17/46 (37%) In those without. Conclusions. Patients with localized SS have a good chance of cure with surgery and RT. Evidence for a well-defined role of chemotherapy to improve survival In localized SS remains elusive.
