Neo/adjuvant chemotherapy does not improve outcome in resected primary synovial sarcoma: a study of the French Sarcoma Group.

Abstract

BACKGROUND:

There are only scarce data about the benefit of adjunctive chemotherapy in patients with localized synovial sarcoma (SS).

PATIENTS AND METHODS:

Data from 237 SS patients recorded in the database of the French Sarcoma Group were retrospectively analyzed. The respective impact of radiotherapy, neo-adjuvant chemotherapy and adjuvant chemotherapy on overall survival (OS), local recurrence-free survival (LRFS) and distant recurrence-free survival (DRFS) were assessed after adjustment to prognostic factors.

RESULTS:

The median follow-up was 58 months (range 1-321). Adjuvant, neo-adjuvant chemotherapy and postoperative radiotherapy were administered in 112, 45 and 181 cases, respectively. In all, 59% of patients treated with chemotherapy received an ifosfamide-containing regimen. The 5-year OS, LRFS and DRFS rates were 64.0%, 70% and 57%, respectively. On multivariate analysis, age >35 years old, grade 3 and not-R0 margins were highly significant independent predictors of worse OS. After adjustment to prognostic factors, radiotherapy significantly improved LRFS but not DRFS or OS. Neither neo-adjuvant nor adjuvant chemotherapy had significant impact on OS, LRFS or DRFS.

CONCLUSION:

As for other high-grade soft-tissue sarcomas, well-planned wide surgical excision with adjuvant radiotherapy remains the cornerstone of treatment for SS. Neo-adjuvant or adjuvant chemotherapy should not be delivered outside a clinical trial setting.

• Authors: A Italiano, N Penel, Y-M Robin, B Bui, A Le Cesne, S Piperno-Neumann, M Tubiana-Hulin, E Bompas, C Chevreau, N Isambert, S Leyvraz, P P du Chatelard, A Thyss, J-M Coindre, J-Y Blay
• Journal: Annals of oncology : official journal of the European Society for Medical Oncology (Ann Oncol) Vol. 20 Issue 3 Pg. 425-30 (Mar 2009) ISSN: 1569-8041 [Electronic] England
• PMID: 19088169 (Publication Type: Journal Article)

Chemical References

• Antineoplastic Agents

Topics

• Adolescent
• Adult
• Aged
• Antineoplastic Agents (therapeutic use)
• Chemotherapy, Adjuvant
• Combined Modality Therapy
• Female
• France
• Humans
• Male
• Middle Aged
• Sarcoma, Synovial (drug therapy, surgery)
• Survival Analysis
• Treatment Outcome