Does the Primary Tumor Site Drive Biology for Patients With Synovial Sarcoma?

Autor:	Patel RR; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center.; Department of Epidemiology., Delclos GL; Department of Environmental and Occupational Health Sciences., DeSantis SM; Department of Biostatistics, The UTHealth Houston School of Public Health., Cannell MB; Department of Epidemiology., Lupo PJ; Department of Pediatrics, Baylor College of Medicine., Bishop AJ; Department of Radiation Oncology., Lazar AJ; Department of Pathology.; Department of Genomic Medicine., Lin PP; Department of Orthopedic Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX., Benjamin RS; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center., Patel SR; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center., Ludwig J; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center., Ravi V; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center., Livingston JA; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center., Somaiah N; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center., Zarzour MA; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center., Conley AP; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center., Araujo DM; Department of Sarcoma Medical Oncology, The University of Texas MD Anderson Cancer Center.
Jazyk:	angličtina
Zdroj:	American journal of clinical oncology [Am J Clin Oncol] 2025 Jan 01; Vol. 48 (1), pp. 21-27. Date of Electronic Publication: 2024 Sep 03.
DOI:	10.1097/COC.0000000000001142
Abstrakt:	Objective: We evaluated survival outcomes by primary tumor site in synovial sarcoma (SS) patients with localized and metastatic disease at diagnosis. Methods: We conducted a retrospective review of 504 SS patients diagnosed from 1974 to 2020. Kaplan-Meier method, log-rank test, and Cox-proportional hazards regression were used. Results: Among 504 patients, 401 (79.6%) presented with localized disease, and 103 (20.4%) with metastases. For patients with localized disease, (1) 5-year OS by tumor site was as follows: 80% (95% CI, 67%-89%) for head/neck, 30% (95% CI, 18%-42%) for intrathoracic, 51% (95% CI, 35%-65%) for abdomen/pelvis, 71% (95% CI, 62%-79%) for proximal-extremity, and 83% (71%, 91%) for distal-extremity. (2) On multivariable analysis, tumor site (compared with proximal-extremity: intrathoracic tumors [HR: 1.95; 95% CI, 1.22-3.16]; hand/foot [HR: 0.52; 95% CI, 0.28-0.97]), tumor size (compared with <5 cm, 5-10 cm [HR: 1.80; 95% CI, 1.14-2.85]; ≥10 cm [HR: 4.37; 95% CI, 2.69-7.11]), and use of neo/adjuvant radiation (HR: 0.54; 95% CI, 0.37-0.79) remained significantly associated with OS. For patients with metastatic disease, (1) 5-year OS was 12% (95% CI, 6%-21%) and (2) the only factor that remained significantly associated with OS on multivariable analysis was surgical resection for the primary tumor (HR: 0.14; 95% CI, 0.08-0.26). Conclusions: The primary tumor location plays a significant role in predicting outcomes for patients with localized SS. Even though patients present with metastatic disease, surgical resection of the primary tumor improves their survival. These findings are critical for patient counseling and designing a personalized treatment plan that reflects the corresponding outcomes. Competing Interests: The authors report no conflicts of interest. (Copyright © 2024 Wolters Kluwer Health, Inc. All rights reserved.)
Databáze:	MEDLINE
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