Localized synovial sarcoma of the foot or ankle: A series of 32 Cooperative Weichteilsarkom Study Group patients

Scheer, Monika; Greulich, M.; Loff, Steffan; Vokuhl, Christian; Feuchtgruber, Simone; Kalle, Thekla von; Münter, Marc W.; Stegmaier, Sabine; Sparber‐Sauer, Monika; Kazanowska, Bernarda; Niggli, Felix; Fuchs, Jörg; Bielack, Stefan; Klingebiel, Thomas; Kościelniak, Ewa

doi:10.1002/jso.25284

Cited by 11 publications

(13 citation statements)

References 45 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The 5-year overall survival rate of soft tissue sarcomas arising in the foot is 76.3 79%, 3,4,17 and the 5-year overall survival rate of synovial sarcomas arising in the foot has been reported to be 86%, with a better prognosis than for synovial sarcomas in the limbs and trunk. 18 Although the 5-year overall survival rate of limb salvage cases in this study showed good prognosis at 94.7%, the 9 cases that underwent belowknee amputation at our hospital (Table 3) showed a significantly poorer prognosis at 55.6% (Fig. 3).…”

Section: Discussionmentioning

confidence: 50%

Limb salvage surgery without radiation therapy for soft tissue sarcomas of the foot

Hayakawa

Matsumoto

et al. 2021

Foot & Ankle Surgery: Techniques, Reports & Cases

View full text Add to dashboard Cite

Combined limb salvage surgery and radiation therapy has been gaining traction for the treatment of soft tissue sarcomas of the foot in recent years. However, limb salvage surgery without radiation therapy is more desirable. In this study, we obtained good results from limb salvage surgery without radiation therapy in soft tissue sarcoma of the foot. Twenty patients histologically diagnosed with soft tissue sarcoma who underwent limb salvage surgery, including ray amputation, were evaluated. Their mean age was 39 years. The mean follow-up period was 94.5 months (6 355 months). The histological diagnoses included 9 cases of synovial sarcoma. Treatment, local recurrence rate, survival rate, complication, and ADL were evaluated. Surgical procedures consisted of ray amputation in 5 cases and limb salvage surgery in 15. Of these 15 cases, 14 (93%) required reconstructive surgery for skin defects. One patient (5%) exhibited recurrence. The 5-year overall survival rate was 94.7%, and the 5-year local progression-free survival rate was 92.9%. Early postoperative complications were found in 5 of 20 cases (25%), comprising flap failure in 4 cases and infection in 1 case; however, all patients eventually demonstrated good functional outcomes. In this study, the recurrence rate was 5% for patients who underwent limb salvage surgery without radiation therapy, and we obtained good local control. Since the anatomical structures of the foot act as barriers to tumor progression, the use of a method of evaluating resection margins to determine the extent of resection enabled successful surgery, not combined with radiation, without the recurrence of sarcomas.

show abstract

Section: Discussionmentioning

confidence: 50%

Limb salvage surgery without radiation therapy for soft tissue sarcomas of the foot

Hayakawa

Matsumoto

et al. 2021

Foot & Ankle Surgery: Techniques, Reports & Cases

View full text Add to dashboard Cite

show abstract

“…2,4 We observed a similar 5-year OS rate (88%) for patients presenting with localized disease as described in previously published case series. [7][8][9] For example, Outani et al 7 reported an 80% 5-year OS with 5 hand SS patients. Scully et al 8 reported a 5-year OS of 79% with 14 foot SS patients, and Scheer et al 9 showed the rate to be 86% in 32 foot and ankle SS patients.…”

Section: Discussionmentioning

confidence: 99%

“…The overall 5-year survival rate for all SS is known to be around 50% to 60%, 6 whereas it may be 80% to 86% for hand and foot SS. [7][8][9] The current literature mostly consists of case reports and series with limited cases of either hand or foot SS. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In addition, there is a paucity of literature on hand and foot SS patients presenting with localized disease compared with metastatic disease.…”

mentioning

confidence: 99%

“…[7][8][9] The current literature mostly consists of case reports and series with limited cases of either hand or foot SS. [7][8][9][10][11][12][13][14][15][16][17][18][19][20][21] In addition, there is a paucity of literature on hand and foot SS patients presenting with localized disease compared with metastatic disease. Given our SS referral center, we sought to better define the outcomes of this rare group of patients.…”

mentioning

confidence: 99%

See 1 more Smart Citation

Synovial Sarcoma of the Hand and Foot

Patel

Lupo

Bishop

et al. 2021

American Journal of Clinical Oncology

View full text Add to dashboard Cite

Objectives: Synovial sarcomas (SS) arising in distal extremities are rare and have been studied using mostly case reports and small series. We aimed to evaluate clinical presentation and survival outcomes for patients with hand or foot SS. Materials and Methods:We conducted a retrospective review of 84 patients diagnosed with primary hand (n = 20) and foot (n = 64) SS between 1979 and 2019. Progression-free survival (PFS), overall survival (OS), local recurrence-free survival and metastasis-free survival were estimated using the Kaplan-Meier method and log-rank test. Coxproportional hazards regression was used to estimate the hazard ratios.Results: Of 84 patients, 63 (75%) presented with localized disease with 36 years median age at diagnosis (range: 4 to 76) and 21 (25%) with metastasis with 30 years median age at diagnosis (range: 15 to 64). Among patients presenting with localized disease, (1) 5 years-PFS, OS, local recurrence-free survival, and metastasis-free survival rates were 82%, 88%, 100%, and 86%, respectively. (2) Tumor size <3.0 cm corresponded to 95% 5 years-PFS (vs. 84% for 3.0 to 4.9 cm, 53% for ≥ 5.0 cm; P = 0.007) and 100% 5 years-OS (vs. 77% for ≥ 3.0 cm; P = 0.04). (3) Patients with ≥ 5.0 cm (vs. <3.0 cm) tumor size had 7.99 (95% confidence interval: 1.68, 37.91) times higher hazard of progression. Remarkably, patients presenting with metastasis had 50% 5 years-OS rate. Also, younger age (15 to 39 vs. 40 y and above) predicted better OS among patients presenting with localized disease (P = 0.04) and with metastasis (P = 0.03).Conclusions: Survival outcomes are favorable for younger patients with <3.0 cm hand or foot SS. Local control is excellent, but we observed larger tumor size to be associated with poorer outcomes. Therefore, we recommend consideration of systemic therapy for patients with ≥ 3.0 cm hand or foot SS.

show abstract

“…Clinical information, treatment data, and outcome were available for all. Some had been included in previous analysis (pathological slides were reviewed for the purposes of those studies)(Stegmaier et al 2017 ; Scheer et al 2016a ; Scheer et al 2020 ; Scheer et al 2019 ; Scheer et al 2016b ). The SYT–SSX fusion transcript was routinely analyzed since 2000.…”

Section: Methodsmentioning

confidence: 99%

Pre-operative radiotherapy is associated with superior local relapse-free survival in advanced synovial sarcoma

Scheer

Hallmen²,

Vokuhl³

et al. 2022

J Cancer Res Clin Oncol

Self Cite

View full text Add to dashboard Cite

Purpose Optimization of local therapies in synovial sarcoma (SS) considered unresectable at diagnosis is needed. We evaluated the effects of neoadjuvant versus adjuvant radiation versus surgery only on long-term outcomes. Methods Patients with macroscopic SS tumors before chemotherapy (IRS-group-III) in the trials CWS-81, CWS-86, CWS-91, CWS-96, CWS-2002-P and SoTiSaR-registry were analyzed. Local therapies were scheduled after 3 neoadjuvant chemotherapy cycles. Results Median age of 145 patients was 14.5 years. 106 survivors had median follow-up of 7.0 years. Tumor site was 96 extremities, 19 head–neck, 16 shoulder/hip, 14 trunk. Tumors were < 3 cm in 16, 3–5 cm in 28, 5–10 cm in 55, > 10 cm in 34 patients. In a secondary resection during chemotherapy, R0-status was accomplished in 82, R1 in 30, R2 in 21 (12 missing). Radiotherapy was administered to 115 (R0 61, R1 29, R2 20, missing 5), thereof 57 before and 52 after tumor resection. 23 were treated with surgery only. For all patients, 5 year event-free (EFS) and overall survival (OS) was 68.9% ± 7.6 (95%CI) and 79.1% ± 6.9. To establish independent significance, tumor site, size, surgical results and sequencing of local therapies were analyzed in a Cox regression analysis. Variables associated with EFS and OS are site, size and sequencing of local therapies. Variables associated with local recurrence are site, surgical results and sequencing of local therapies. The only variable associated with suffering metastatic recurrence is tumor size. Conclusion Differences in sequencing of local therapy procedures are independently associated with outcomes. Best local control is achieved when tumors are irradiated pre-operatively and undergo R0 or R1 resection thereafter.

show abstract

Localized synovial sarcoma of the foot or ankle: A series of 32 Cooperative Weichteilsarkom Study Group patients

Cited by 11 publications

References 45 publications

Limb salvage surgery without radiation therapy for soft tissue sarcomas of the foot

Limb salvage surgery without radiation therapy for soft tissue sarcomas of the foot

Synovial Sarcoma of the Hand and Foot

Pre-operative radiotherapy is associated with superior local relapse-free survival in advanced synovial sarcoma

Contact Info

Product

Resources

About