Prognostic Factors and Comprehensive Treatment of 95 Synovial Sarcoma Patients

Abstract

Objective To investigate prognostic factors and the efficacy of surgery-based comprehensive treatment for patients with synovial sarcoma. Methods We retrospectively analyzed the medical records of 95 synovial sarcoma patients. Factors associated with survival were identified with univariate analysis by log-rank test and multivariate analysis by Cox proportional hazard regression model. Kaplan-Meier method was applied to do the survival analysis. Results Patients were followed up for 8-296 months and the median follow-up time was 62 months. The median overall survival time of all patients was 76 months (95%CI: 67.9-84.1 months). The 5-year OS and PFS of this cohort were 70.7% and 22.5%, respectively. Multivariable analysis indicated that AJCC staging at diagnosis (P < 0.001), primary tumor site (P=0.027), tumor size (P=0.015), time of adjuvant therapy (P=0.004), therapeutic regimen (P=0.005) and recurrence and metastasis (P=0.016) were independent prognostic factors of OS. Kaplan-Meier method showed that the median overall survival time of patients with more than 4 courses chemotherapy was 84 months, significantly better than 66 months of those patients with less than 4 courses(P=0.007). Conclusion Several clinical features could affect the prognosis of synovial sarcoma. Adjuvant chemotherapy, adjuvant radiotherapy and combining radiotherapy and chemotherapy are all effective for prolonging patients' survival time. After surgery, a sooner adjuvant therapy before disease progression could achieve better treatment effect. For patients accepting chemotherapy, 4 and above chemotherapy courses are favorable to obtain better therapeutic results.

Keywords

• synovial sarcoma
• surgery
• chemotherapy
• radiotherapy
• prognostic factors