TY - JOUR
T1 - Neo/adjuvant chemotherapy does not improve outcome in resected primary synovial sarcoma
T2 - A study of the French Sarcoma Group
AU - Italiano, A.
AU - Penel, N.
AU - Robin, Y. M.
AU - Bui, B.
AU - Le Cesne, A.
AU - Piperno-Neumann, S.
AU - Tubiana-Hulin, M.
AU - Bompas, E.
AU - Chevreau, C.
AU - Isambert, N.
AU - Leyvraz, S.
AU - du Chatelard, P. P.
AU - Thyss, A.
AU - Coindre, J. M.
AU - Blay, J. Y.
PY - 2009/1/1
Y1 - 2009/1/1
N2 - 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.
AB - 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.
KW - Adjuvant chemotherapy
KW - Neo-adjuvant chemotherapy
KW - Radiotherapysynovial sarcoma
UR - http://www.scopus.com/inward/record.url?scp=61649093785&partnerID=8YFLogxK
U2 - 10.1093/annonc/mdn678
DO - 10.1093/annonc/mdn678
M3 - Article
C2 - 19088169
AN - SCOPUS:61649093785
SN - 0923-7534
VL - 20
SP - 425
EP - 430
JO - Annals of Oncology
JF - Annals of Oncology
IS - 3
ER -