Chemotherapy is associated with improved survival in adult patients with primary extremity synovial sarcoma.

Abstract

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 (>or=16 years) with >or=5 cm, deep, primary, extremity, synovial sarcoma that underwent surgical treatment of cure from 1990 to 2002. A total of 101 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.

• Authors: Fritz C Eilber, Murray F Brennan, Frederick R Eilber, Jeffery J Eckardt, Stephen R Grobmyer, Elyn Riedel, Charles Forscher, Robert G Maki, Samuel Singer
• Journal: Annals of surgery (Ann Surg) Vol. 246 Issue 1 Pg. 105-13 (Jul 2007) ISSN: 0003-4932 [Print] United States
• PMID: 17592298 (Publication Type: Journal Article, Multicenter Study, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Antibiotics, Antineoplastic
• Antineoplastic Agents, Alkylating
• Doxorubicin
• Ifosfamide

Topics

• Adolescent
• Adult
• Aged
• Antibiotics, Antineoplastic (therapeutic use)
• Antineoplastic Agents, Alkylating (therapeutic use)
• Arm
• Disease-Free Survival
• Doxorubicin (therapeutic use)
• Female
• Follow-Up Studies
• Humans
• Ifosfamide (therapeutic use)
• Leg
• Male
• Middle Aged
• Neoplasm Recurrence, Local (mortality)
• Prospective Studies
• Sarcoma, Synovial (drug therapy, mortality)
• Survival Rate (trends)
• Treatment Outcome