Long-Term Outcomes for Synovial Sarcoma Treated With Conservation Surgery and Radiotherapy

B. Ashleigh Guadagnolo, Gunar K. Zagars, Matthew Ballo, Shreyaskumar R. Patel, Valerae O. Lewis, Peter W T Pisters, Robert S. Benjamin, Raphael E. Pollock

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Abstract

Purpose: To evaluate prognostic factors and treatment outcomes in patients with localized synovial sarcoma treated with conservation surgery and radiotherapy (RT). Methods and Materials: Between 1960 and 2003, 150 patients with nonmetastatic synovial sarcoma were treated with conservation surgery and RT. The majority of patients (81%) were aged >20 years. Sixty-eight percent received postoperative RT, and 32% received preoperative RT. Forty-eight percent received adjuvant chemotherapy. Results: Median follow-up was 13.2 years. Overall survival (OS) rates at 5, 10, and 15 years were 76%, 57%, and 51%, respectively. Corresponding disease-free survival (DFS) rates were 59%, 52%, and 52%, respectively. Tumor size >5 cm predicted worse OS, DFS, disease-specific survival (DSS), and higher rate of distant metastases (DM). Age >20 years predicted worse DFS and DSS but not OS. Local control (LC) was 82% at 10 years. Positive or unknown resection margins predicted inferior LC rates. Forty-four percent developed DM by 10 years. Only 1% developed nodal metastases. Analysis of outcomes by treatment decade showed no significant differences with respect to LC and DM rates. Conclusions: Synovial sarcoma is adequately controlled at the primary site by conservation surgery and RT. Elective nodal irradiation is not indicated. Rates of development of DM and subsequent death from disease remain high, with no significant improvement in outcomes for this disease in the past four decades.

Original languageEnglish (US)
Pages (from-to)1173-1180
Number of pages8
JournalInternational Journal of Radiation Oncology Biology Physics
Volume69
Issue number4
DOIs
StatePublished - Nov 15 2007
Externally publishedYes

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Synovial Sarcoma
surgery
conservation
radiation therapy
Radiotherapy
cancer
Neoplasm Metastasis
metastasis
Disease-Free Survival
Survival Rate
Survival
Adjuvant Chemotherapy
chemotherapy
death
margins
tumors
Neoplasms
irradiation

All Science Journal Classification (ASJC) codes

  • Oncology
  • Radiology Nuclear Medicine and imaging
  • Radiation

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Long-Term Outcomes for Synovial Sarcoma Treated With Conservation Surgery and Radiotherapy. / Guadagnolo, B. Ashleigh; Zagars, Gunar K.; Ballo, Matthew; Patel, Shreyaskumar R.; Lewis, Valerae O.; Pisters, Peter W T; Benjamin, Robert S.; Pollock, Raphael E.

In: International Journal of Radiation Oncology Biology Physics, Vol. 69, No. 4, 15.11.2007, p. 1173-1180.

Research output: Contribution to journalArticle

Guadagnolo, B. Ashleigh ; Zagars, Gunar K. ; Ballo, Matthew ; Patel, Shreyaskumar R. ; Lewis, Valerae O. ; Pisters, Peter W T ; Benjamin, Robert S. ; Pollock, Raphael E. / Long-Term Outcomes for Synovial Sarcoma Treated With Conservation Surgery and Radiotherapy. In: International Journal of Radiation Oncology Biology Physics. 2007 ; Vol. 69, No. 4. pp. 1173-1180.
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