Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2008 Dec 15;14(24):8191-7.
doi: 10.1158/1078-0432.CCR-08-0843.

A synovial sarcoma-specific preoperative nomogram supports a survival benefit to ifosfamide-based chemotherapy and improves risk stratification for patients

Robert J Canter  1 , Li-Xuan Qin, Robert G Maki, Murray F Brennan, Marc Ladanyi, Samuel Singer
Affiliations

A synovial sarcoma-specific preoperative nomogram supports a survival benefit to ifosfamide-based chemotherapy and improves risk stratification for patients

Robert J Canter et al. Clin Cancer Res. .

Abstract

Purpose: To identify prognostic factors related to outcome in 255 patients with synovial sarcoma and to construct a preoperative nomogram to predict the risk of disease-specific death.

Design: Between July 1982 and June 2006, 301 patients underwent treatment at our institution for primary synovial sarcoma of all anatomic sites and 255 patients with localized disease at presentation were resected with curative intent. Data were collected prospectively and analyzed retrospectively.

Results: Five-, 10-, and 15-year disease-specific survival (DSS) was 72%, 60%, and 53%, respectively. Multivariate analysis revealed size and primary tumor site as the only independent adverse predictors of disease-specific death. A nomogram based on preoperative data for surgical patients not receiving anthracycline-ifosfamide (AI) chemotherapy (n = 196) estimates 3- and 5-year DSS with a concordance index of 77.3%. For the first 3 years following diagnosis, the observed DSS for patients treated with AI chemotherapy (n = 59) was greater than that predicted by the preoperative nomogram based on patients not receiving AI chemotherapy. SYT-SSX fusion transcript data were available for 132 patients. Multivariate analysis of this subset showed that SYT-SSX1 fusion type was predictive of early, but not late, distant recurrence.

Conclusion: Size and location govern prognosis in primary synovial sarcoma resected with curative intent. A nomogram based on preoperative variables provides individualized patient survival estimates and shows an early survival benefit to chemotherapy that may dissipate over time. This nomogram may improve decision-making with regards to selecting patients most likely to benefit from neoadjuvant/adjuvant chemotherapy.

PubMed Disclaimer

Figures

Figure 1
Figure 1
A. Kaplan-Meier curve depicting disease-specific survival grouped by primary tumor size. Univariate P values are shown. B. Kaplan-Meier curve depicting disease-specific survival grouped by site of primary tumor. Univariate P values are shown. C. Kaplan-Meier curve depicting disease-specific survival grouped by type of fusion transcript. Univariate P values are shown.
Figure 1
Figure 1
A. Kaplan-Meier curve depicting disease-specific survival grouped by primary tumor size. Univariate P values are shown. B. Kaplan-Meier curve depicting disease-specific survival grouped by site of primary tumor. Univariate P values are shown. C. Kaplan-Meier curve depicting disease-specific survival grouped by type of fusion transcript. Univariate P values are shown.
Figure 1
Figure 1
A. Kaplan-Meier curve depicting disease-specific survival grouped by primary tumor size. Univariate P values are shown. B. Kaplan-Meier curve depicting disease-specific survival grouped by site of primary tumor. Univariate P values are shown. C. Kaplan-Meier curve depicting disease-specific survival grouped by type of fusion transcript. Univariate P values are shown.
Figure 2
Figure 2
A. Kaplan-Meier curve depicting distant recurrence-free survival grouped by primary tumor size. Univariate P values are shown. B. Kaplan-Meier curve depicting distant recurrence-free survival grouped by site of primary tumor. Univariate P values are shown. C. Kaplan-Meier curve depicting distant recurrence-free survival grouped by type of fusion transcript. Univariate P values are shown.
Figure 2
Figure 2
A. Kaplan-Meier curve depicting distant recurrence-free survival grouped by primary tumor size. Univariate P values are shown. B. Kaplan-Meier curve depicting distant recurrence-free survival grouped by site of primary tumor. Univariate P values are shown. C. Kaplan-Meier curve depicting distant recurrence-free survival grouped by type of fusion transcript. Univariate P values are shown.
Figure 2
Figure 2
A. Kaplan-Meier curve depicting distant recurrence-free survival grouped by primary tumor size. Univariate P values are shown. B. Kaplan-Meier curve depicting distant recurrence-free survival grouped by site of primary tumor. Univariate P values are shown. C. Kaplan-Meier curve depicting distant recurrence-free survival grouped by type of fusion transcript. Univariate P values are shown.
Figure 3
Figure 3
Nomogram based on preoperative variables used to calculate synovial sarcoma-specific 3 and 5-year survival.
Figure 4
Figure 4
Kaplan-Meier curve depicting observed disease-specific survival (with 95% confidence intervals) for patients treated with ifosfamide-containing chemotherapy compared to disease-specific survival predicted by the preoperative nomogram for otherwise similar patients treated without ifosfamide-based chemotherapy.
See this image and copyright information in PMC

References

    1. Brennan MF, Singer S, Maki RG, O’Sullivan B. Sarcomas of the Soft Tissues and Bone. In: Vincent DeVita, Samuel Hellman, Steven Rosenberg., editors. Cancer: Principles and Practice of Oncology. 7th Edition. Lippincott, Williams, and Wilkins; 2005. pp. 1581–1637.
    1. Singer S, Demetri GD, Baldini EH, Fletcher CD. Management of soft-tissue sarcomas: an overview and update. Lancet Oncol. 2000;1:75–85. - PubMed
    1. Rosen G, Forscher C, Lowenbraun S, et al. Synovial sarcoma. Uniform response of metastases to high dose ifosfamide. Cancer. 1994;73(10):2506–2511. - PubMed
    1. Kampe CE, Rosen G, Eilber F, et al. Synovial sarcoma. A study of intensive chemotherapy in 14 patients with localized disease. Cancer. 1993;72(7):2161–2169. - PubMed
    1. Eilber FC, Brennan MF, Eilber FR, et al. Chemotherapy is associated with improved survival in adult patients with primary extremity synovial sarcoma. Ann Surg. 2007;246(1):105–113. - PMC - PubMed

Publication types

Substances