Perioperative radiotherapy is associated with improved survival among patients with synovial sarcoma: A SEER analysis

Naing, K.W.; Monjazeb, Arta M.; Li, Chin‐Shang; Lee, Li-Yuan; Yang, Anthony D.; Borys, Dariusz; Canter, Robert J.

doi:10.1002/jso.23780

Cited by 44 publications

(42 citation statements)

References 33 publications

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“…They observed an improvement in 3-y survival for patients with high-grade tumors receiving RT compared with those not receiving RT (73% versus 63%, P < 0.001). Not surprisingly, given the overlap in study patients, our results reinforce the findings of previous studies such as those of Koshy et al ., specifically the positive effects of RT, as well as female sex, married marital status, and later years of diagnosis on improved oncologic outcome [10,22]. Furthermore, similar to prior studies, we identified tumor size and grade to be strong predictors of worse oncologic outcome [5,6,20].…”

Section: Discussionsupporting

confidence: 81%

“…Although previous studies have evaluated the impact of RT on OS and DSS in the multimodality management of various STS, the results have been equivocal [3,6,8–11,22,23]. Although there is clear benefit of RT on improved local control, some studies have demonstrated improved survival with RT, whereas randomized prospective trials by Yang et al .…”

Section: Discussionmentioning

confidence: 99%

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Older age impacts radiotherapy-related outcomes in soft tissue sarcoma

Yuen

Monjazeb

et al. 2015

Journal of Surgical Research

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Background Radiation therapy (RT) is a standard component in the multimodality management of localized soft tissue sarcoma (STS). Increasing studies are focusing on biological modifiers that may influence the host’s response to RT, including immunologic mechanisms known to change with the aging process. We hypothesized that the effects of RT would be influenced by age, contributing to differences in treatment outcome. Methods Using Surveillance, Epidemiology, and End Results (1990–2011), we identified 30,898 adult patients (>18 y) with nonmetastatic STS undergoing initial surgery. We compared patient demographics, tumor characteristics, and treatments by age. Multivariable analyses were used to analyze overall survival (OS) and disease-specific survival (DSS). Hazard ratios (HRs) were calculated based on multivariable Cox proportional hazards models. Results Mean age at diagnosis was 56.6 ± 16.8 y, and 33.6% of patients were ≥65 y. Of the total, 52.1% of patients were male and 67% were white; 59.9% of patients underwent surgery alone, 33.3% received adjuvant RT, and 6.8% neoadjuvant RT. On multivariable analysis, age, sex, year of diagnosis, histology, grade, size, marital status, and RT predicted OS, whereas age, year of diagnosis, ethnicity, histology, site, grade, RT, size, and marital status predicted DSS. In all patients, RT was associated with improved OS and DSS compared to surgery alone (median OS 136 ± 13 mo with RT versus 118 ± 9 mo without RT and 5-y OS 63.2 ± 1.4% with RT versus 60.5 ± 1.2% without, P < 0.01). Patients ≥65 y derived greater improvements in OS and DSS compared with patients <65 y. These benefits were most notable after neoadjuvant RT with patients ≥65 y having significantly better OS (HR = 0.63; 95% confidence interval = 0.53–0.75), whereas patients <65 y did not (HR = 0.96; 95% confidence interval = 0.83–1.10). In addition, interaction testing demonstrated a significant modifier effect between RT and age (P < 0.05). Conclusions RT is associated with improved survival in patients with STS undergoing surgical treatment, but improvements in oncologic outcome with RT were greatest among older patients. Further studies into the mechanism of these age-related effects are needed.

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Section: Discussionsupporting

confidence: 81%

Section: Discussionmentioning

confidence: 99%

Older age impacts radiotherapy-related outcomes in soft tissue sarcoma

Yuen

Monjazeb

et al. 2015

Journal of Surgical Research

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“…Compared with adjuvant chemotherapy, fewer reports have focused on adjuvant radiotherapy in SS patients. Using the Surveillance, Epidemiology, and End Results database, Naing et al showed that adjuvant radiotherapy improved OS in SS patients. Song et al reported that adjuvant radiotherapy improved LRFS but did not affect OS in patients with localized SS.…”

Section: Discussionmentioning

confidence: 99%

Localized synovial sarcoma: A single institutional study of 191 patients with a minimum follow‐up of 5 years for survivors

Outani

Nakamura

Murata

et al. 2019

Journal of Surgical Oncology

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Purpose Factors affecting long‐term outcomes of synovial sarcoma (SS) remain unknown. Here, we aimed to investigate the long‐term oncological outcomes and prognostic factors in a large group of patients with surgically‐treated localized SS. Patients and Methods Between 1980 and 2011, 191 patients (94 males and 97 females) were treated at a single hospital with a minimum follow‐up of 5 years for survivors. The median age was 35 years (range, 3‐80 years), and the median follow‐up period was 83 months (range, 3‐235 months). Results Disease‐specific survival was 76.4% and 60.4% at 5 and 10 years, respectively. Local recurrence occurred in 23 patients at a median of 33 months (range, 6‐158 months), and metastasis occurred in 73 patients at a median of 20 months (range, 2‐166 months). In multivariate analysis, grade 3 tumors sized ≥5 cm were significantly associated with worse survival. Ten patients (5.2%) developed metastasis more than 5 years after surgery. Conclusion Tumor size and grade govern prognosis in surgically‐treated localized SS in long‐term settings. If adequately treated patients have not developed metastases for 5 years after surgery, the risk of subsequently developing metastases was lower than previously reported.

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“…Although radiotherapy has failed to show effect on survival in randomized controlled trials in heterogeneous soft tissue sarcoma populations, some retrospective studies reporting specifically on synovial sarcoma have identified adjuvant radiation as associated with better outcome. Song et al reported that adjuvant radiation was associated with improved progression free survival within their institution, and Naing et al identified an association between perioperative radiotherapy and prolonged disease‐specific survival in SEER. In the current study, adjuvant radiation was associated with prolonged OS in the overall cohort and among stage III patients specifically.…”

Section: Discussionmentioning

confidence: 99%