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Simple Summary: Synovial sarcoma in the head and neck region is rare, making up just 2–3% of sarcomas in that area. This anatomic location is challenging to treat due to its proximity to vital structures like the airways and cranial nerves. Studying this rare malignant tumor at an early, localized stage is important, as multidisciplinary treatments might improve survival outcomes. Therefore, this study aims to explore the survival outcomes of patients with localized head and neck synovial sarcomas. We find that radiation therapy is associated with improved local control of the tumor. While the role of perioperative chemotherapy is still debatable in synovial sarcoma patients, we observe that undergoing chemotherapy in addition to surgery and radiation can promote metastasis-free survival in patients with localized head and neck synovial sarcomas, especially when the tumor is ≥4 cm. By providing updated information on this rare cancer type, such findings may help improve treatment approaches and outcomes, benefiting both patients and the medical community. Background: this study aims to evaluate the survival outcomes of patients suffering from head and neck synovial sarcoma (HNSS), especially in relation to patients with a localized disease at diagnosis. Methods: this retrospective chart review includes 57 patients diagnosed with primary HNSS between 1981 and 2020 who presented with a localized disease at diagnosis. Overall survival (OS) from diagnosis, local recurrence-free survival (LRFS), and metastasis-free survival (MFS) from the end of the primary tumor treatment are estimated. The Kaplan–Meier method, the log-rank test, and the Cox proportional hazards regression are used. Results: the 5-year OS, LRFS, and MFS are estimated at 80.4% (95% CI: 66.6%, 88.9%), 67.7% (95% CI: 50.0%, 80.4%), and 50.6% (95% CI: 34.4%, 64.8), respectively. Compared to patients undergoing surgical resection alone, those receiving radiation therapy (RT) with surgery have better LRFS (HR: 0.03, 95% CI: 0.001, 0.57), and those undergoing neo/adjuvant chemotherapy with surgery and RT have better MFS (HR: 0.10, 95% CI: 0.01, 0.95). Moreover, among the patients with tumors ≥ 4 cm, those subject to neo/adjuvant chemotherapy have significantly better MFS (5-year MFS: 53.2%, 95% CI: 29.0%, 72.5%) than those treated with surgery and RT alone (5-year MFS: 20.0%, 95% CI: 0.8%, 58.2%) (LR-p = 0.003). Conclusions: overall, the prognosis of HNSS patients looks favorable. Perioperative RT significantly improves local control, and perioperative chemotherapy plays a vital role in delaying metastasis formation in patients with primary HNSS when diagnosed with a localized disease. Importantly, we recommend that systemic therapy should be considered for HNSS patients with tumors ≥ 4 cm. [ABSTRACT FROM AUTHOR]

Simple Summary: A urine drug test (UDT) is often used in the treatment of cancer pain to monitor compliance with opioid treatment. Two types of UDT are commonly for this purpose: the immunoassay test, and the mass spectrometry method. Only a few studies have examined the use of immunoassay UDT for cancer patients in palliative care clinics. In this study, we examined the frequency of immunoassay UDT abnormalities, and the factors associated with aberrant findings at a safety-net hospital palliative medicine clinic. Electronic medical records of 913 patients were reviewed. We found that 27% had aberrant UDT results; 35% of these were positive for cocaine. Non-Hispanic White race, history of illicit drug use, and history of marijuana use were associated with an aberrant finding. Despite limitations of immunoassay UDT, it could detect aberrant drug-taking behaviors in a significant number of patients. These findings support the utility of immunoassay UDT in clinical settings with less resources. Background: Few studies have examined the use of immunoassay urine drug testing of cancer patients in palliative care clinics. Objectives: We examined the frequency of immunoassay urine drug test (UDT) abnormalities and the factors associated with aberrancy at a safety-net hospital palliative medicine clinic. Methods: A retrospective review of the electronic medical records of consecutive eligible patients seen at the outpatient palliative medicine clinic in a resource-limited safety-net hospital system was conducted between 1 September 2015 and 31 December 2020. We collected longitudinal data on patient demographics, UDT findings, and potential predictors of aberrant results. Results: Of the 913 patients in the study, 500 (55%) underwent UDT testing, with 455 (50%) having the testing within the first three visits. Among those tested within the first three visits, 125 (27%) had aberrant UDT results; 44 (35%) of these 125 patients were positive for cocaine. In a multivariable regression model analysis of predictors for aberrant UDT within the first three visits, non-Hispanic White race (odds ratio (OR) = 2.13; 95% confidence interval (CI): 1.03–4.38; p = 0.04), history of illicit drug use (OR = 3.57; CI: 1.78–7.13; p < 0.001), and history of marijuana use (OR = 7.05; CI: 3.85–12.91; p < 0.001) were independent predictors of an aberrant UDT finding. Conclusion: Despite limitations of immunoassay UDT, it was able to detect aberrant drug-taking behaviors in a significant number of patients seen at a safety-net hospital palliative care clinic, including cocaine use. These findings support universal UDT monitoring and utility of immunoassay-based UDT in resource-limited settings. [ABSTRACT FROM AUTHOR]