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Salvage Treatment Experience in Advanced Synovial Sarcoma: a Multicenter Retrospective Analysis of the Anatolian Society of Medical Oncology

  • Yetisyigit, Tarkan (Medical Oncology Department, Namık Kemal University Hospital) ;
  • Arpaci, Erkan (Medical Oncology Department, Dr. Abdurrahman Yurtaslan Education and Research Hospital) ;
  • Seber, Erdogan Selcuk (Medical Oncology Department, Marmara University) ;
  • Kucukoner, Mehmet (Medical Oncology Department, Dicle University) ;
  • Kos, Fatma Tugba (Medical Oncology Department, Ankara Numune Education and Research Hospital) ;
  • Sonmez, Ozlem Uysal (Medical Oncology Department, Dr. Abdurrahman Yurtaslan Education and Research Hospital) ;
  • Alici, Suleyman (Medical Oncology Department, Goztepe Medical Park Hospital) ;
  • Akman, Tulay (Medical Oncology Department, Kartal Education and Research Hospital) ;
  • Aktas, Bilge (Medical Oncology Department, Marmara University) ;
  • Yildiz, Ramazan (Medical Oncology Department, Dokuz Eylul University) ;
  • Gunaydin, Yusuf (Medical Oncology Department, Dokuz Eylul University) ;
  • Inanc, Mevlude ;
  • Demirci, Umut (Medical Oncology Department, Dokuz Eylul University) ;
  • Alkis, Necati (Medical Oncology Department, Dr. Abdurrahman Yurtaslan Education and Research Hospital) ;
  • Gumus, Mahmut (Kartal Education and Research Hospital)
  • Published : 2013.09.30

Abstract

Background: We aimed to evaluate prognostic factors and response rates to various treatment approaches to patients with synovial sarcoma in an advanced setting. Materials and Methods: We retrospectively reviewed the medical records of 55 patients (18 pts; 32.7% women) diagnosed with synovial sarcomas. Twenty had metastatic disease at the time of diagnosis while the remainder of the study group consisted of patients who developed metastatic or inoperable locally advanced disease during follow up. Results: The median follow up time was 15 months (range: 1-53). Regarding outcomes for the 55 patients, 3 and 5 year overall survival rates were 26% and 14%, respectively. In univariate analyses among demographic factors female gender was associated with a better outcome (p=0.030). Patients with early progressing disease (<2 years) had a worse prognosis when compared to patient group with late relapse, but this difference did not reach statistical significance (p=0.056). According to multivariate Cox regression analysis patients who had undergone metastasectomy had a significant survival advantage (p=0.044). The overall response rate to different salvage chemotherapy regimens given as second line treatment was around 42.9-53.9% for all regimes. There were no statistically significant differences between chemotherapy regimens given in either second or third line settings in terms of overall survival. Conclusions: We observed no major differences in terms of response rate and survival between different salvage chemotherapy regimens. Although metastatic disease still carries a poor prognosis, metastasectomy was found to be associated with improved survival.

Keywords

Synovial sarcoma;advanced disease;salvage chemotherapy;prognostic factors;metastasectomy

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