Monika Scheer, Christian Oliver Vokuhl, Sebastian Bauer, Jörg Fuchs, Steffan Loff, Beate Timmermann, Marc Münter, Anton George Henssen, Bernarda Kazanowska, Felix Niggli, Ruth Ladenstein, Gustaf Ljungman, Ewa Koscielniak, Thomas Klingebiel
- Background: The benefit of adjuvant therapy in synovial sarcoma (SS) treatment is under debate. Long-term follow-up data are missing.
Methods: SS patients treated in the consecutive trials CWS-81, CWS-86, CWS-91, CWS-96, CWS-2002-P, and the SoTiSaR-registry till 2013 were analyzed.
Results: Median age of 185 patients was 13.9 years (0.1–56)—with median follow-up of 7.4 years for 163 survivors. Most tumors (76%) were located in extremities. Size was < 3 cm in 58 (31%), 3–5 cm in 59 (32%), 5–10 cm in 42 (23%), and > 10 cm in 13 (7%) (13 missing). In 84 (45%) tumors, first excision was complete (R0 corresponding to IRS-I-group) and in 101 (55%) marginal (R1 corresponding to IRS-II-group). In a subsequent surgical intervention during chemotherapy, R0-status was accomplished in 23 additional IRS-II-group patients with secondary surgery. Radiotherapy was administered to 135 (73%), thereof 62 with R0-status and 67 R1-status (6 missing information). Adjuvant chemotherapy was administered to all but six patients. 5-year event-free (EFS) and overall survival (OS) was 82.9% ± 5.7 (95%CI) and 92.5% ± 3.9. Local and metastatic relapse-free survival was 91.3% ± 4.3 and 92.3% ± 4.1 at 5 years, respectively. In the multivariate analysis, tumor size and no chemotherapy were independently associated with EFS. Size and site were associated with OS. In a detailed analysis of local and metastatic events, tumor size was associated with an independent risk for developing metastases. No independent factor for suffering local recurrence could be identified.
Discussion: Omission of chemotherapy in a non-stratified way seems not justified. Size governs survival due to high linear association with risk of suffering metastatic recurrence in a granular classification.
MetadatenAuthor: | Monika ScheerORCiD, Christian Oliver VokuhlORCiDGND, Sebastian BauerORCiDGND, Jörg FuchsGND, Steffan LoffGND, Beate TimmermannGND, Marc MünterGND, Anton George HenssenGND, Bernarda KazanowskaORCiD, Felix NiggliGND, Ruth LadensteinORCiD, Gustaf LjungmanORCiD, Ewa KoscielniakORCiD, Thomas KlingebielORCiDGND |
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URN: | urn:nbn:de:hebis:30:3-695165 |
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DOI: | https://doi.org/10.1007/s00432-021-03614-6 |
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ISSN: | 1432-1335 |
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Parent Title (English): | Journal of cancer research and clinical oncology |
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Publisher: | Springer |
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Place of publication: | Berlin ; Heidelberg |
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Document Type: | Article |
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Language: | English |
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Date of Publication (online): | 2021/07/17 |
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Date of first Publication: | 2021/07/17 |
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Publishing Institution: | Universitätsbibliothek Johann Christian Senckenberg |
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Contributing Corporation: | European Cooperative Weichteilsarkom Studiengruppe [CWS] |
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Release Date: | 2023/06/20 |
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Tag: | Adjuvant therapies; Chemotherapy; Pediatric sarcoma; Radiotherapy; Soft-tissue sarcoma; Synovial sarcoma |
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Volume: | 147 |
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Issue: | 12 |
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Page Number: | 13 |
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First Page: | 3735 |
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Last Page: | 3747 |
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Note: | Open Access funding enabled and organized by Projekt DEAL. Supported by the German Childhood Cancer Foundation, Bonn; German Cancer Aid, Bonn; Federal Ministry of Research and Technology, Bonn and the Förderkreis Krebskranke Kinder e.V. Stuttgart, Germany. |
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HeBIS-PPN: | 510039294 |
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Institutes: | Medizin / Medizin |
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Dewey Decimal Classification: | 6 Technik, Medizin, angewandte Wissenschaften / 61 Medizin und Gesundheit / 610 Medizin und Gesundheit |
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Sammlungen: | Universitätspublikationen |
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Licence (German): | Creative Commons - CC BY - Namensnennung 4.0 International |
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