Prognostic factors in localized primary synovial sarcoma: a multicenter study of 128 adult patients.

Détails

ID Serval
serval:BIB_C7DB42A3B340
Type
Article: article d'un périodique ou d'un magazine.
Collection
Publications
Titre
Prognostic factors in localized primary synovial sarcoma: a multicenter study of 128 adult patients.
Périodique
Journal of Clinical Oncology
Auteur(s)
Trassard M., Le Doussal V., Hacène K., Terrier P., Ranchère D., Guillou L., Fiche M., Collin F., Vilain M.O., Bertrand G., Jacquemier J., Sastre-Garau X., Bui N.B., Bonichon F., Coindre J.M.
ISSN
0732-183X
Statut éditorial
Publié
Date de publication
2001
Peer-reviewed
Oui
Volume
19
Numéro
2
Pages
525-534
Langue
anglais
Résumé
PURPOSE: To identify most significant and therapeutically relevant prognostic factors in adults with localized primary synovial sarcomas (SS) and to confirm the usefulness of the French Federation of Cancer Centers (FNCLCC) grading system, the prognostic impact of which has been already proven in soft tissue sarcomas. PATIENTS AND METHODS: Data on 128 patients with nonmetastatic SS collected from a cooperative database by the FNCLCC Sarcoma Group between 1980 and 1994 were studied retrospectively. Immunohistochemistry was performed at diagnosis in 77 cases (61%). The tumors were classified as biphasic (n = 45), monophasic fibrous (n = 72), and poorly differentiated (n = 10) subtypes. Histologic grade was determined according to the FNCLCC method, and vascular invasion was assessed in every case. RESULTS: The 5-year disease-specific survival (DSS) rate for this series of patients with localized SS was 62.9% (+/- 9.6% [SD]) with a median follow-up time of 37 months (range, 8 to 141 months). In multivariate analysis, the adverse risk factors associated with decreased DSS were International Union Against Cancer/American Joint Committee on Cancer stage III/IVA disease, male sex, and truncal tumor locations. For metastasis-free survival (MFS), disease stage III/IVA, tumor necrosis, and monophasic subtypes were the major factors associated with a less favorable prognosis. Separately, when not using disease stage, tumor necrosis, and mitotic activity, histologic grade became the most significant prognostic factor for both DSS and MFS. In addition, larger tumors and older patients become associated with a significantly worse prognosis. Independent adverse risk factors for local recurrence-free survival included histologic grade 3 and truncal tumor location. CONCLUSION: These data confirm that not all SS present the same severe outcome. High-risk patients identified on the basis of these parameters may qualify for an aggressive treatment approach.
Mots-clé
Adult, Female, Humans, Immunohistochemistry, Male, Multivariate Analysis, Neoplasm Staging, Prognosis, Proportional Hazards Models, Retrospective Studies, Sarcoma, Synovial/mortality, Sarcoma, Synovial/pathology, Survival Analysis
Pubmed
Web of science
Création de la notice
29/01/2008 19:35
Dernière modification de la notice
03/03/2018 21:20
Données d'usage