Myrella Vlenterie1, Saskia Litière2, Elisa Rizzo2, Sandrine Marréaud2, Ian Judson3, Hans Gelderblom4, Axel Le Cesne5, Eva Wardelmann6, Christina Messiou3, Alessandro Gronchi7, Winette Ta van der Graaf8. 1. Department of Medical Oncology, Radboud University Medical Center, Nijmegen, The Netherlands. 2. European Organization for Research and Treatment of Cancer (EORTC) Head Quarters, Brussels, Belgium. 3. The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, UK. 4. Department of Medical Oncology, Leiden University Medical Center, Leiden, The Netherlands. 5. Institut Gustave Roussy, Villejuif, France. 6. Gerhard Domagk Institute for Pathology, University Hospital Muenster, Muenster, Germany. 7. Surgery, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy. 8. The Institute of Cancer Research and the Royal Marsden NHS Foundation Trust, London, UK. Electronic address: winette.vandergraaf@icr.ac.uk.
Abstract
INTRODUCTION: Previous studies in metastatic soft tissue sarcomas (STS) showed that synovial sarcomas tend to have better survival rates and a higher chemosensitivity than other STS subtypes. However, data are derived from relatively small subgroups and statistical significance of these observations is lacking. Larger cohorts are necessary to define and confirm the specific characteristics of this subtype. PATIENTS AND METHODS: Patient data were retrieved from 15 European Organisation for Research and Treatment of Cancer advanced first-line STS trials. Patient characteristics, survival and treatment response of synovial sarcoma patients were compared to other STS patients. Univariable and multivariable analyses were performed to evaluate prognostic factors. RESULTS: In total, 3330 advanced STS patients were retrieved, of whom 313 had a synovial sarcoma. Synovial sarcoma patients were significantly younger (median 40 versus 52 years), more often had extremity primary tumours and had a better performance status (PS 0: 50.2 versus 43.4%) compared to other STS patients. Additionally, synovial sarcoma patients had a significantly better response to chemotherapy (responders: 27.8 versus 18.8%) and better survival rates (progression free survival [PFS]: 6.3 versus 3.7 months; Overall survival [OS]: 15.0 versus 11.7 months). Age, PS, and presence of metastatic disease were defined as prognostic factors for PFS and OS in the univariable analysis. The last two factors were confirmed in the multivariable analysis for OS. DISCUSSION: Advanced synovial sarcomas are a distinct subgroup of STS, with a better response to systemic chemotherapy and longer PFS and OS. These results should be taken into account in the design of future synovial sarcoma specific studies.
INTRODUCTION: Previous studies in metastatic soft tissue sarcomas (STS) showed that synovial sarcomas tend to have better survival rates and a higher chemosensitivity than other STS subtypes. However, data are derived from relatively small subgroups and statistical significance of these observations is lacking. Larger cohorts are necessary to define and confirm the specific characteristics of this subtype. PATIENTS AND METHODS: Patient data were retrieved from 15 European Organisation for Research and Treatment of Cancer advanced first-line STS trials. Patient characteristics, survival and treatment response of synovial sarcomapatients were compared to other STS patients. Univariable and multivariable analyses were performed to evaluate prognostic factors. RESULTS: In total, 3330 advanced STS patients were retrieved, of whom 313 had a synovial sarcoma. Synovial sarcomapatients were significantly younger (median 40 versus 52 years), more often had extremity primary tumours and had a better performance status (PS 0: 50.2 versus 43.4%) compared to other STS patients. Additionally, synovial sarcomapatients had a significantly better response to chemotherapy (responders: 27.8 versus 18.8%) and better survival rates (progression free survival [PFS]: 6.3 versus 3.7 months; Overall survival [OS]: 15.0 versus 11.7 months). Age, PS, and presence of metastatic disease were defined as prognostic factors for PFS and OS in the univariable analysis. The last two factors were confirmed in the multivariable analysis for OS. DISCUSSION: Advanced synovial sarcomas are a distinct subgroup of STS, with a better response to systemic chemotherapy and longer PFS and OS. These results should be taken into account in the design of future synovial sarcoma specific studies.
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