The effect of adjuvant therapies on long-term outcome for primary resected synovial sarcoma in a series of mainly children and adolescents
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| Titel: | The effect of adjuvant therapies on long-term outcome for primary resected synovial sarcoma in a series of mainly children and adolescents |
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| Autoren: | Scheer, Monika, Vokuhl, Christian, Bauer, Sebastian, Fuchs, Jörg, Loff, Steffan, Timmermann, Beate, Münter, Marc, Henssen, Anton George, Kazanowska, Bernarda, Niggli, Felix, Ladenstein, Ruth, Ljungman, Gustaf, Koscielniak, Ewa, Klingebiel, Thomas, European Cooperative Weichteilsarkom Studiengruppe [CWS] |
| Weitere Verfasser: | European Cooperative Weichteilsarkom Studiengruppe CWS |
| Quelle: | J Cancer Res Clin Oncol |
| Verlagsinformationen: | Springer Science and Business Media LLC, 2021. |
| Publikationsjahr: | 2021 |
| Schlagwörter: | Adult, Male, Medicin och hälsovetenskap, Cancer Research, Adolescent, Original Article – Clinical Oncology, Medizin, Adolescent [MeSH], Female [MeSH], Sarcoma, Synovial/therapy [MeSH], Radiotherapy, Adjuvant/methods [MeSH], Combined Modality Therapy/methods [MeSH], Adult [MeSH], Humans [MeSH], Middle Aged [MeSH], Pediatric sarcoma, Infant [MeSH], Male [MeSH], Time [MeSH], Adjuvant therapies, Young Adult [MeSH], Chemotherapy, Chemotherapy, Adjuvant/methods [MeSH], Soft-tissue sarcoma, Child [MeSH], Radiotherapy, Synovial sarcoma, Child, Preschool [MeSH], Medical and Health Sciences, Time, Sarcoma, Synovial, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Humans, Child, ddc:610, Infant, Middle Aged, Combined Modality Therapy, 3. Good health, Chemotherapy, Adjuvant, Child, Preschool, Female, Radiotherapy, Adjuvant, 600 Technik, Medizin, angewandte Wissenschaften::610 Medizin und Gesundheit::610 Medizin und Gesundheit |
| Beschreibung: | Background The benefit of adjuvant therapy in synovial sarcoma (SS) treatment is under debate. Long-term follow-up data are missing. Methods SS patients treated in the consecutive trials CWS-81, CWS-86, CWS-91, CWS-96, CWS-2002-P, and the SoTiSaR-registry till 2013 were analyzed. Results Median age of 185 patients was 13.9 years (0.1–56)—with median follow-up of 7.4 years for 163 survivors. Most tumors (76%) were located in extremities. Size was 10 cm in 13 (7%) (13 missing). In 84 (45%) tumors, first excision was complete (R0 corresponding to IRS-I-group) and in 101 (55%) marginal (R1 corresponding to IRS-II-group). In a subsequent surgical intervention during chemotherapy, R0-status was accomplished in 23 additional IRS-II-group patients with secondary surgery. Radiotherapy was administered to 135 (73%), thereof 62 with R0-status and 67 R1-status (6 missing information). Adjuvant chemotherapy was administered to all but six patients. 5-year event-free (EFS) and overall survival (OS) was 82.9% ± 5.7 (95%CI) and 92.5% ± 3.9. Local and metastatic relapse-free survival was 91.3% ± 4.3 and 92.3% ± 4.1 at 5 years, respectively. In the multivariate analysis, tumor size and no chemotherapy were independently associated with EFS. Size and site were associated with OS. In a detailed analysis of local and metastatic events, tumor size was associated with an independent risk for developing metastases. No independent factor for suffering local recurrence could be identified. Discussion Omission of chemotherapy in a non-stratified way seems not justified. Size governs survival due to high linear association with risk of suffering metastatic recurrence in a granular classification. |
| Publikationsart: | Article Other literature type |
| Dateibeschreibung: | application/pdf; application/zip |
| Sprache: | English |
| ISSN: | 1432-1335 0171-5216 |
| DOI: | 10.1007/s00432-021-03614-6 |
| DOI: | 10.17169/refubium-39938 |
| Zugangs-URL: | https://link.springer.com/content/pdf/10.1007/s00432-021-03614-6.pdf https://pubmed.ncbi.nlm.nih.gov/34272609 https://link.springer.com/content/pdf/10.1007/s00432-021-03614-6.pdf https://www.ncbi.nlm.nih.gov/pubmed/34272609 https://link.springer.com/article/10.1007/s00432-021-03614-6 https://paperity.org/p/269661699/the-effect-of-adjuvant-therapies-on-long-term-outcome-for-primary-resected-synovial https://pubmed.ncbi.nlm.nih.gov/34272609/ https://edoc.mdc-berlin.de/20483/ http://edoc.mdc-berlin.de/20483/1/20483oa.pdf https://repository.publisso.de/resource/frl:6449888 http://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-459715 |
| Rights: | CC BY URL: http://creativecommons.org/licenses/by/4.0/Open AccessThis article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (http://creativecommons.org/licenses/by/4.0/) . |
| Dokumentencode: | edsair.doi.dedup.....8667be913f8f684176e4c3fcb454cb32 |
| Datenbank: | OpenAIRE |
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Nájsť tento článok vo Web of Science | Abstract: | Background The benefit of adjuvant therapy in synovial sarcoma (SS) treatment is under debate. Long-term follow-up data are missing. Methods SS patients treated in the consecutive trials CWS-81, CWS-86, CWS-91, CWS-96, CWS-2002-P, and the SoTiSaR-registry till 2013 were analyzed. Results Median age of 185 patients was 13.9 years (0.1–56)—with median follow-up of 7.4 years for 163 survivors. Most tumors (76%) were located in extremities. Size was 10 cm in 13 (7%) (13 missing). In 84 (45%) tumors, first excision was complete (R0 corresponding to IRS-I-group) and in 101 (55%) marginal (R1 corresponding to IRS-II-group). In a subsequent surgical intervention during chemotherapy, R0-status was accomplished in 23 additional IRS-II-group patients with secondary surgery. Radiotherapy was administered to 135 (73%), thereof 62 with R0-status and 67 R1-status (6 missing information). Adjuvant chemotherapy was administered to all but six patients. 5-year event-free (EFS) and overall survival (OS) was 82.9% ± 5.7 (95%CI) and 92.5% ± 3.9. Local and metastatic relapse-free survival was 91.3% ± 4.3 and 92.3% ± 4.1 at 5 years, respectively. In the multivariate analysis, tumor size and no chemotherapy were independently associated with EFS. Size and site were associated with OS. In a detailed analysis of local and metastatic events, tumor size was associated with an independent risk for developing metastases. No independent factor for suffering local recurrence could be identified. Discussion Omission of chemotherapy in a non-stratified way seems not justified. Size governs survival due to high linear association with risk of suffering metastatic recurrence in a granular classification. |
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| ISSN: | 14321335 01715216 |
| DOI: | 10.1007/s00432-021-03614-6 |