Prognostic Factors in Localized Primary Synovial Sarcoma: A Multicenter Study of 128 Adult Patients

Trassard, Martine; Doussal, V. Le; Hacène, K.; Terrier, Philippe; Ranchère, Dominique; Guillou, Louis; Fiche, Maryse; Collin, Françoise; Vilain, M O; Bertrand, G.; Jacquemier, Jocelyne; Sastre-Garau, Xavier; Nb, Bui; Bonichon, F.; Coindre, Jean‐Michel

doi:10.1200/jco.2001.19.2.525

Cited by 258 publications

(254 citation statements)

References 39 publications

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“…During the last several decades, much effort has been invested in determining prognostic factors affecting overall survival in patients with synovial sarcoma. Histologic subtype, tumor grade, anatomic location, age, gender, tumor size, and surgical margins have been reported to have prognostic implication for a patient's overall survival [1,2,6,9,12,16,17,[19][20][21][22][23][24]. In our study, histologic subtype, grade, anatomic location, size, age, and surgical margins did not predict overall survival.…”

Section: Discussioncontrasting

confidence: 44%

“…There are approximately 800 new cases of synovial sarcoma per year in the United States [26]. Historically, synovial sarcoma has been associated with poor prognosis, with survival at 5 years ranging from 55% to 76% [2,16,20,21,23,27]. However, with advances in molecular biology and classification, it has emerged all synovial sarcomas do not share the same tumor biology when it comes to local recurrence, metastasis, and survival [2,16,17,[19][20][21][22][23].…”

Section: Introductionmentioning

confidence: 99%

“…Primary tumor size [1,2,12,16,17,[20][21][22][23]27], tumor stage [20,23], gender [6,23,27], age [2,6,12,17,19,21,27], tumor grade [6,23], histologic subtype [2,17,19,20,23], tumor necrosis [23], mitotic activity [23], invasion of bone and neurovascular structures [1,16], and anatomic tumor location [6,9,17,19,23] all influence the natural history of primary synovial sarcomas. However, many of these findings have not been consistent so definitive conclusions based on them cannot be made.…”

Section: Introductionmentioning

confidence: 99%

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Risk Assessment Based on FDG-PET Imaging in Patients with Synovial Sarcoma

Lisle

Eary

O’Sullivan

et al. 2008

Clin Orthop Relat Res

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Synovial sarcoma generally is associated with poor prognosis. With recent advances in molecular biology, it has become apparent not all synovial sarcomas share the same tumor biology. 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) is useful for risk assessment in several types of sarcomas. We therefore assessed the clinical value of 18 F-FDG-PET-derived maximum standard uptake value (SUV max ) for predicting survival in patients with synovial sarcoma. 18 F-FDG-PET was performed in 44 patients with synovial sarcoma before therapy and resection. SUV max was calculated for each tumor and then evaluated for prognostic usefulness along with metastasis at presentation, tumor grade, histopathologic subtype, age, gender, postsurgical margins, anatomic location, and tumor size for overall survival and progression-free survival. SUV max ranged from 1.2 to 13.0 (median, 4.35). Pretherapy tumor SUV max predicted overall survival and progression-free survival. Patients presenting with a SUV max greater than 4.35 had a decreased diseasefree survival and were therefore at high risk for having local recurrences and metastatic disease.

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Section: Discussioncontrasting

confidence: 44%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Risk Assessment Based on FDG-PET Imaging in Patients with Synovial Sarcoma

Lisle

Eary

O’Sullivan

et al. 2008

Clin Orthop Relat Res

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“…We observed that frequent mitosis, sex (male), visceral location, and large tumor size were poor prognostic factors in multivariate analysis. High mitotic activity 16,17 and large tumor size [16][17][18][19] were consistently reported as adverse prognostic factors for SS. To our knowledge, the prognostic implications of visceral locations have not been assessed; however, truncal/proximal tumors reportedly confer a worse prognoses than tumors of the distal extremities.…”

Section: Discussionmentioning

confidence: 99%

“…This difference in survival according to sex also was observed in previous large studies. 17,20 Takenaka et al Figure 3. Kaplan-Meier survival curves illustrate overall survival according to the results from immunohistochemical studies of (A) phosphorylated Akt (pAkt), (B) phosphorylated mammalian target of rapamycin (pmTOR), (C) phosphorylated eukaryotic translation initiation factor 4E-binding protein (p4E-BP1), and (D) phosphorylated S6 ribosomal protein (pS6).…”

Section: Discussionmentioning

confidence: 99%

Prognostic impact of the activation status of the Akt/mTOR pathway in synovial sarcoma

Setsu

Kohashi

Fushimi

et al. 2013

Cancer

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BACKGROUND:The Akt/mammalian target of rapamycin (mTOR) pathway, downstream from phosphatidylinositol 3-kinase (PI3K), mediates cell survival and proliferation. Although this pathway reportedly contributes to the progression of synovial sarcoma, its prognostic impact has not been clarified. METHODS: The authors analyzed clinicopathologic data and phosphorylation status of Akt (a serine/threonine kinase also known as protein kinase B), mTOR, the eukaryotic translation initiation factor 4E binding protein (4E-BP1), and the S6 ribosomal protein by immunohistochemical analysis of 120 formalin-fixed, paraffin-embedded samples and by Western blot analysis of 24 frozen samples from 112 patients with synovial sarcoma. RESULTS: Akt, mTOR, 4E-BP1, and S6 were activated in 76.5%, 67.6%, 59.6%, and 42.6% of samples, respectively. Immunohistochemically positive phosphorylated (p) mTOR (pmTOR) and p4E-BP1 results were correlated with higher mitotic activity, and positive p4E-BP1 results were correlated with greater necrosis. No mutations around the hot spots in the PI3K catalytic subunit a (PI3KCA) and Akt1 genes were observed. In multivariate analysis of clinicopathologic parameters, frequent mitosis was a risk factor for shorter overall survival; and male sex, visceral location, larger tumor size, and frequent mitosis were identified as risk factors for shorter event-free survival. Positive pmTOR and p4E-BP1 results were correlated significantly with shorter overall survival, and positive p4E-BP1 results were correlated with shorter event-free survival in univariate analysis. Positive pAkt results were associated significantly with shorter event-free survival in multivariate analysis. CONCLUSIONS: In this study, the Akt/mTOR pathway was activated and was associated with worse clinical and pathologic behavior in patients with synovial sarcoma. The authors propose that this pathway may have potential as a therapeutic target.

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Epidemiology and survivorship of soft tissue sarcomas in adults: a national cancer database report

2014

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The National Cancer Data Base (NCDB) of the American College of Surgeons gather demographic and survival data on ∼70% of cancers in the USA. We wanted to investigate the demographic and survivorship data on this potentially more representative cohort of patients with soft tissue sarcomas. We selected 34 of the most commonly encountered soft tissue sarcomas reported to the NCDB, provided that each entity contained a minimum of 50 cases. This report summarizes the demographic and survivorship data on 63,714 patients with these 34 histologically distinct soft tissue sarcomas reported to the NCDB from 1998 to 2010. The overall survivorships of these sarcomas were near the lower limits of many prior reports due to the all-inclusive, minimally biased inclusion criteria. The overall best prognosis was Dermatofibrosarcoma NOS (not otherwise specified). (5-year survivorship 92%). The worst prognosis was Dedifferentiated Chondrosarcoma (5-year survivorship 19%). New observations included Biphasic Synovial Sarcoma demonstrating a better 5-year survivorship (65%) compared to spindle-cell synovial sarcoma (56%, P < 0.031) and Synovial Sarcoma, NOS (52%, P < 0.001). The demographic and 2- and 5-year survivorship data for all 34 soft tissue sarcomas are presented herein. This extent of demographic and survival data in soft tissue sarcomas is unprecedented. Because of the large number of cases and the inclusive nature of the NCDB, without restriction to certain stages, categories, or treatments, it is less subject to selection bias. Therefore, these data are thought to be more reflective of the true overall prognosis given the current management of sarcoma across the NCDB contributing sites.

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Prognostic Factors in Localized Primary Synovial Sarcoma: A Multicenter Study of 128 Adult Patients

Abstract: These data confirm that not all SS present the same severe outcome. High-risk patients identified on the basis of these parameters may qualify for an aggressive treatment approach.

Cited by 258 publications

References 39 publications

Risk Assessment Based on FDG-PET Imaging in Patients with Synovial Sarcoma

Risk Assessment Based on FDG-PET Imaging in Patients with Synovial Sarcoma

Prognostic impact of the activation status of the Akt/mTOR pathway in synovial sarcoma

Epidemiology and survivorship of soft tissue sarcomas in adults: a national cancer database report

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