TY - JOUR
T1 - Synovial sarcoma
T2 - Report of a series of 25 consecutive children from a single institution
AU - Ferrari, Andrea
AU - Casanova, Michela
AU - Massimino, Maura
AU - Luksch, Roberto
AU - Cefalo, Graziella
AU - Lombardi, Fabrizio
AU - Galimberti, Stefania
AU - Riganti, Giorgia
AU - Fossati-Bellani, Franca
PY - 1999/1
Y1 - 1999/1
N2 - Background. The role of postoperative radiotherapy and adjuvant chemotherapy in the treatment of synovial sarcoma remains to be determined. Procedure. Twenty-five children were treated during a 23-year period with a multimodality approach. All of them had resection of the primary tumor (three amputations), followed by surgical retreatment in eight. Postoperative radiotherapy was delivered to 16 patients and adjuvant chemotherapy was given to 22. Results. At the time of the report, 19 patients were alive and without evidence of disease. Six developed distant metastases (one associated with local recurrence); five of them died of their disease and one was alive in complete remission at 4 years from relapse. With a median follow-up of 9 years (range 2-23), the survival and the event-free survival at 5 years were 80% (SE 8.2) and 74% (SE 9.2), respectively. All relapsing patients had been classified as T2B. Conclusions. Multimodality treatment yielded satisfying survival results using limbpreserving surgery in most cases. Tumor size >5 cm and invasiveness, which defined stage T2B, were the most important predictors of poor outcome. Evaluation of the role of adjuvant chemotherapy and radiotherapy awaits prospective studies, even if T2B patients, as well as children having nonradical surgery, seem worth managing by adjuvant treatments.
AB - Background. The role of postoperative radiotherapy and adjuvant chemotherapy in the treatment of synovial sarcoma remains to be determined. Procedure. Twenty-five children were treated during a 23-year period with a multimodality approach. All of them had resection of the primary tumor (three amputations), followed by surgical retreatment in eight. Postoperative radiotherapy was delivered to 16 patients and adjuvant chemotherapy was given to 22. Results. At the time of the report, 19 patients were alive and without evidence of disease. Six developed distant metastases (one associated with local recurrence); five of them died of their disease and one was alive in complete remission at 4 years from relapse. With a median follow-up of 9 years (range 2-23), the survival and the event-free survival at 5 years were 80% (SE 8.2) and 74% (SE 9.2), respectively. All relapsing patients had been classified as T2B. Conclusions. Multimodality treatment yielded satisfying survival results using limbpreserving surgery in most cases. Tumor size >5 cm and invasiveness, which defined stage T2B, were the most important predictors of poor outcome. Evaluation of the role of adjuvant chemotherapy and radiotherapy awaits prospective studies, even if T2B patients, as well as children having nonradical surgery, seem worth managing by adjuvant treatments.
KW - Pediatric cancer
KW - Soft tissue sarcoma
KW - Synovial sarcoma
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U2 - 10.1002/(SICI)1096-911X(199901)32:1<32::AID-MPO7>3.0.CO;2-1
DO - 10.1002/(SICI)1096-911X(199901)32:1<32::AID-MPO7>3.0.CO;2-1
M3 - Article
C2 - 9917750
AN - SCOPUS:0032953485
VL - 32
SP - 32
EP - 37
JO - Pediatric Blood and Cancer
JF - Pediatric Blood and Cancer
SN - 1545-5009
IS - 1
ER -