Chemosensitivity of Lung Metastatic High-Grade Synovial Sarcoma

C. Tetta, G. Montrone, A. Longhi, M. Rocca, F. Londero, G. Parise, O. Parise, J.G. Maessen, M. Miceli, S. Gelsomino*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review

Abstract

Background: Synovial sarcoma is a relatively chemosensitive type of soft tissue sarcoma and it often metastasizes to the lung. We investigated the role of adjuvant chemotherapy in patients with high-grade synovial sarcoma at their first lung metastasectomy (LMTS). Methods: Forty-six HGSS patients had their first LMTS at our institute (Rizzoli Orthopedic Hospital, Bologna, Italy) between 2000 and 2020. We divided them into two groups: (1) those undergoing adjuvant chemotherapy (n = 24) and (2) those not receiving adjuvant chemotherapy (n = 22). The primary outcome was a median survival at 32.5 (IQR 18.0-82.7) median follow-up. The disease-free interval was calculated at time zero (DFI0, interval between the diagnosis of the primary tumor and the first CT-diagnosed lung metastasis) and at any further lung relapse (DFI1-3). T-0 was defined as the time at first LMTS and T-1-T-3 referred to the time of further metastasectomy. Results: Freedom from SS-specific mortality at 60 months was significantly higher in patients without chemotherapy (50.0% (33.0-76.0%) vs. 20.8% (9.55%-45.4%), p = 0.01). Chemotherapy was associated with a higher risk of SS-specific mortality at multivariable Cox regression (HR 2.8, p = 0.02). Furthermore, DFI0 <= 6 months, female sex, age > 40 years, and primary tumor > 10 cm increased the risk of death by about four, six, >three, and >five times, respectively. Conclusions. Adjuvant chemotherapy did not show any advantage in terms of freedom from SS-specific mortality in HGSS patients. Further larger studies are necessary to confirm our findings.
Original languageEnglish
Article number5956
Number of pages12
JournalJournal of Clinical Medicine
Volume10
Issue number24
DOIs
Publication statusPublished - 1 Dec 2021

Keywords

  • synovial sarcoma
  • chemotherapy
  • lung metastases
  • lung metastasectomy
  • soft tissue sarcoma
  • SOFT-TISSUE SARCOMA
  • EUROPEAN-ORGANIZATION
  • RETROSPECTIVE ANALYSIS
  • PROGNOSTIC-FACTORS
  • PULMONARY METASTASECTOMY
  • ADULT PATIENTS
  • CHEMOTHERAPY
  • IFOSFAMIDE
  • DOXORUBICIN
  • ADRIAMYCIN

Cite this