1. Does synovial sarcoma grade predict oncologic outcomes, and does a low-grade variant exist?
- Author
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Fice M, Almajnooni A, Gusho C, Chapman R, Mallikarjunappa S, Batus M, Gitelis S, Colman M, Miller I, and Blank A
- Subjects
- Adult, Humans, Margins of Excision, Retrospective Studies, Time Factors, Sarcoma pathology, Sarcoma, Synovial pathology, Sarcoma, Synovial therapy
- Abstract
Background and Objectives: While historically aggressive, some synovial sarcomas (SS) are clinically indolent. This study sought to determine whether SS grade predicts oncologic outcomes and whether Grade 1 disease might exist., Methods: Thirty-five cases from 2010 to 2019 were retrospectively reviewed. Clinicopathological data were analyzed and Kaplan-Meier assessed survival., Results: The median patient age was 37 years (interquartile range: 28-51.5). The local control rate was 74.3%, and recurrence-free survival (RFS) was worse in positive versus negative margin resections (p = 0.023). The incidence of metastasis was 21.9% (n = 7) at a median 31 ± 31.7 months, and metastasis-free survival was 50.0% in Grade 3 SS versus 86.5% in Grade 2 (p = 0.026). Among a theoretical Grade 1 group, the overall survival (OS) and RFS profiles were improved compared to Grade 2 and 3 SS, respectively (p = 0.014 and p = 0.030). The Grade 1 group had a 15.8% (n = 3) metastatic rate and 80% 10-year survival., Conclusions: Tumor grade appears to predict outcomes in SS. A theoretical Grade 1 group showed improved OS and RFS versus Grades 2 and 3 SS, with metastatic rates and long-term survival resembling the historical literature for other low-grade soft tissue sarcomas. Our group continues to support the French Federation of Cancer Centers diagnostic strategy and NCCN treatment guidelines for SS., (© 2022 Wiley Periodicals LLC.)
- Published
- 2022
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