Prognosis of T1 synovial sarcoma depends upon surgery by oncologic surgeons

Beaino, Marc El; Araujo, Dejka M.; Gopalakrishnan, Vancheswaran; Lazar, Alexander J.; Lin, Patrick P.

doi:10.1002/jso.24306

Cited by 12 publications

(12 citation statements)

References 24 publications

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“…It may be suspected that the rate of primary re-excision was high because malignancy was not suspected in many cases at the time of initial surgery and there was uncertainty about the adequacy of the surgical margins. Indeed, 54% of patients who underwent primary re-excision had residual tumour found, which was quite similar to the rate previously reported in both paediatric and adult patients with soft tissue sarcomas [22–24]. The fact that few local recurrences occurred in patients who had undergone primary re-excision suggests that the need to do two operations is not, per se, a contraindication to omission of adjuvant therapy.…”

Section: Discussionsupporting

confidence: 84%

Surgery alone is sufficient therapy for children and adolescents with low-risk synovial sarcoma: A joint analysis from the European paediatric soft tissue sarcoma Study Group and the Children's Oncology Group

Ferrari

Yun

Salvo

et al. 2017

European Journal of Cancer

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Background Multimodal risk-adapted treatment is used in paediatric protocols for synovial sarcoma (SS). Retrospective analyses suggest that low-risk SS patients can be safely treated with surgery alone, but no prospective studies have confirmed the safety of this approach. This analysis pooled data from the two prospective clinical trials to assess outcomes in SS patients treated with a surgery-only approach and to identify predictors of treatment failure. Methods Patients with localised SS enrolled on the European paediatric Soft tissue sarcoma Study Group (EpSSG) NRSTS2005 and on the Children Oncology Group (COG) ARST0332 trials, treated with surgery alone were eligible for this analysis. Patients must have undergone initial complete resection with histologically free margins, with a grade 2 tumour of any size or a grade 3 tumour ≤5 cm. Results Sixty patients under 21 years of age were eligible for the analysis; 36 enrolled in the COG (from 2007 to 2012) and 24 in the EpSSG study (from 2005 to 2012). The 3-year event-free survival was 90% (median follow-up 5.2 years, range 1.9–9.1). All eight events were local tumour recurrence, whereas no metastatic recurrences were seen. All patients with recurrence were effectively salvaged, resulting in 100% overall survival. Conclusion This joint prospective analysis showed that patients with adequately resected ≤5 cm SS, regardless of grade, can be safely treated with a surgery-only approach. Avoiding the use of adjuvant chemotherapy and radiotherapy in this low-risk patient population may decrease both short- and long-term morbidity and mortality.

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Section: Discussionsupporting

confidence: 84%

Surgery alone is sufficient therapy for children and adolescents with low-risk synovial sarcoma: A joint analysis from the European paediatric soft tissue sarcoma Study Group and the Children's Oncology Group

Ferrari

Yun

Salvo

et al. 2017

European Journal of Cancer

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“…Sixteen of 28 studies focused on localized disease [ 4 , 12 , 23 , 31 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 ], 10/28 studies included both localized and metastatic disease [ 11 , 25 , 28 , 29 , 30 , 44 , 45 , 46 , 47 , 48 ], and 2/28 studies focused on metastatic disease [ 49 , 50 ] ( Table 1 ). Definitions of disease status were infrequently reported; generally just stating whether the population included was either localized or non-metastatic without staging information.…”

Section: Resultsmentioning

confidence: 99%

“…Details on whether patients were considered resectable were reported in 14 studies ( Table 3 ). Of the included studies, eight were conducted in North America [ 4 , 23 , 33 , 34 , 39 , 42 , 45 , 48 ], 15 in Europe [ 11 , 25 , 28 , 29 , 31 , 35 , 36 , 37 , 38 , 40 , 41 , 43 , 46 , 47 , 49 , 50 ], two in Japan [ 30 , 44 ], and two were multi-regional [ 12 , 51 ]. Length of study follow-up ranged from 12.3 months [ 51 ] to 11.4 years (137 months) [ 38 ] for localized disease and from 51 months [ 44 ] to 78 months [ 45 ] for metastatic disease ( Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

“…SS is associated with local recurrence and distant metastases. Metastases occur in 50–70% of cases [ 23 ]; most metastases develop in the lungs (80%), followed by bone (10%) and liver (5%) [ 5 ]. Locally advanced or metastatic SS tends to be treated initially with systemic anti-cancer therapy [ 24 ], however, there is no consensus regarding the most appropriate therapy regimen or sequence.…”

Section: Introductionmentioning

confidence: 99%

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Systemic Anti-Cancer Therapy in Synovial Sarcoma: A Systematic Review

Riedel

Jones

Italiano

et al. 2018

Cancers

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Synovial sarcoma (SS) is an aggressive malignancy which accounts for approximately 5–10% of all soft-tissue sarcomas. SS has pathologic and genomic characteristics that define it as a distinct subtype of soft tissue sarcoma (STS). STS subtypes continue to be recognized as distinct entities with specific characteristics, including differential chemo-sensitivity. The objective of this study was to conduct a descriptive review of current data on survival outcomes of systemic anti-cancer therapy specific to SS. A systematic literature review was conducted, using a custom search strategy to search EMBASE, Medline and CENTRAL for clinical trials and observational studies reporting overall survival (OS), progression-free survival (PFS) and/or response for cohorts of at least 50 SS patients. We identified 28 studies meeting these criteria, 25 of which were retrospective studies. Only three prospective studies were identified. Survival reports varied widely between studies based on the population, in particular on the disease stage, and reporting was heterogeneous in terms of the time points reported on. For patients with localized disease, reports of five-year PFS ranged from 26% to 80.7% and five-year OS from 40% to 90.7%, whereas five-year OS for patients with metastatic disease was very low at around 10%; and in one case, 0% was reported. Only four of the included publications reported outcomes by type of systemic anti-cancer therapy received. Our study draws attention to the fact that additional prospective studies to better define the most appropriate treatment for SS in all stages and lines of therapy are still needed.

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“…The symptoms of SS are pain and a localized mass at an early stage, and joint damage can be found when the tumor progresses. Many patients are diagnosed at an advanced stage because of the atypical symptoms and the rapid progression of the tumor ( 2 ). Sustained proliferation of the tumor cells combined with insufficient apoptosis plays an important role in tumor progression.…”

Section: Introductionmentioning

confidence: 99%

Beclin1 overexpression suppresses tumor cell proliferation and survival via an autophagy‑dependent pathway in human synovial sarcoma cells

Zhu

Cai

et al. 2018

Oncol Rep

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Beclin1 is an important autophagy-related protein, which is involved in both autophagy and apoptosis. In recent years, the antitumor effect of Beclin1 has received increased attention. In the present study, we established a stable Beclin1-overexpressing cell line with SW982 human synovial sarcoma cells. We found that Beclin1 overexpression decreased the cell viability, inhibited proliferation and induced apoptosis in SW982 cells. The expression levels of Bcl-2 and PCNA were decreased, while the levels of cleaved-caspase-3 and cleaved-PARP were increased. Beclin1 is closely related with autophagy, thus the autophagy-related markers LC3 and p62 were detected by western blot analysis, and transmission electron microscopy was used to observe autophagosomes. The results showed that the expression level of LC3II was increased and that of p62 was decreased. Moreover, many double membrane-enclosed autophagosomes were found in cells with Beclin1 overexpression, which indicated that the autophagic activity was enhanced. To explore the effect of autophagy on the viability of SW982 cells, Atg5 was knocked down using siRNA to inhibit the autophagic activity. We found that autophagy contributed to the decrease in cell viability. Knockdown of Atg5 increased the viability and decreased the apoptotic rate of SW982 cells with Beclin1 overexpression. The expression level of Bcl-2 was increased, while the expression levels of cleaved-caspase-3 and cleaved-PARP were decreased. We also found that the Akt/Bcl-2/caspase-9 pathway was involved. The phosphorylation of AKT was positively correlated with cell viability. The cleavage of caspase-9 was increased by Beclin1 overexpression and decreased by inhibition of autophagy. Altogether, our results suggested that both autophagy and apoptosis contributed to the antitumor effect of Beclin1 in SW982 cells.

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Prognosis of T1 synovial sarcoma depends upon surgery by oncologic surgeons

Cited by 12 publications

References 24 publications

Surgery alone is sufficient therapy for children and adolescents with low-risk synovial sarcoma: A joint analysis from the European paediatric soft tissue sarcoma Study Group and the Children's Oncology Group

Surgery alone is sufficient therapy for children and adolescents with low-risk synovial sarcoma: A joint analysis from the European paediatric soft tissue sarcoma Study Group and the Children's Oncology Group

Systemic Anti-Cancer Therapy in Synovial Sarcoma: A Systematic Review

Beclin1 overexpression suppresses tumor cell proliferation and survival via an autophagy‑dependent pathway in human synovial sarcoma cells

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