Treatment outcomes for patients with synovial sarcoma of the head and neck

Lee, Nancy; Shin, Edward J.

doi:10.1586/14737140.8.3.371

Cited by 36 publications

(25 citation statements)

References 12 publications

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“…Patients usually present a painless slow growing mass during their third and fourth decade of life with associated compressive or infiltrative symptom of surrounding structures, and males tend to be affected more often than females [5]. Consistent with the literature, our five patients were all men and their median age was 35 years (range 22 to 41 years).…”

Section: Discussionsupporting

confidence: 72%

“…Local or distant failure is seen in approximately 80% of cases, and lung metastasis is the usual cause of death in patients with SS of the head and neck [5,15]. Penel et al reported that poor prognostic factors of this tumor include initial metastasis or the presence of lymphadenopathy, absence of surgery and number of surgical procedures [16].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Primary synovial sarcoma of the parapharyngeal space: a clinicopathologic study of five cases

Zhu

Wang

et al. 2012

World J Surg Onc

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We report five cases of primary synovial sarcomas arising in the parapharyngeal space. The patients were all men with a median age of 35 years (range 22 to 41 years). The tumors were non-encapsulated solid masses ranging from 2.0 to 6.6 cm in size. Histologically, three cases were biphasic subtype, and the other two cases were monophasic subtype. Immunohistochemically, the tumor cells were strongly positive for bcl-2 and CD99, partly positive for CK and EMA, and negative for CD117, CD34, SMA and desmin in all five cases. S-100 protein was detected in one case. The presence of an SYT–SSX1 and/or SYT-SSX2 gene fusion resulting from t(X;18) was demonstrated from paraffin blocks by reverse transcriptase polymerase chain reaction in five cases. All five patients received tumor radical excision and postoperative radiotherapy, and two patients with pulmonary metastasis received additional chemotherapy. Follow-up data revealed that two patients with tumor size <5 cm were alive without disease for 54 and 57 months, one patient with tumor size <5 cm was alive with pulmonary metastasis for 78 months, and two patients with tumor size >5 cm died of disease 26 and 37 months after the diagnosis, respectively. Primary parapharyngeal synovial sarcoma is a rare variant that occurs more frequently in males than females. Accurate diagnosis depends on morphologic and immunohistochemical examination and proper molecular analysis. The prognosis is relatively good in those patients whose tumor size is less than 5 cm.

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Section: Discussionsupporting

confidence: 72%

Section: Discussionmentioning

confidence: 99%

Primary synovial sarcoma of the parapharyngeal space: a clinicopathologic study of five cases

Zhu

Wang

et al. 2012

World J Surg Onc

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“…This reflects the use of these two modalities as the mainstay of treatment of SCSHN with chemotherapy more frequently used for large tumors, extensive or recurrent disease, and high-risk sites of presentation such as the skull base or paraspinal neck. 27,29,30,40 Interestingly, neither surgical resection nor radiotherapy was found to have a statistically significant survival advantage using multivariate analysis on either the overall or cohorts separated by size at the 5 cm critical size cutoff. This may reflect the near universal treatment of these tumors with surgical resection and the high propensity for adjuvant radiotherapy for disease control.…”

Section: Discussionmentioning

confidence: 95%

Factors Associated With Survival in Patients With Synovial Cell Sarcoma of the Head and Neck

Clair

Arshi

Abemayor

et al. 2016

JAMA Otolaryngol Head Neck Surg

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Importance: Synovial cell sarcoma of the head and neck (SCSHN) is a rare tumor associated with significant morbidity and mortality. The literature regarding these tumors is limited to case series and case reports. We utilized data from the population-based United States SEER cancer registry to determine factors affecting both overall survival and disease specific survival of patients with SCSHN. Objective: To determine the clinicopathologic and therapeutic factors determining survival in patients with SCSHN. Design, Setting, and Participants: The Surveillance, Epidemiology, and End Results registry was reviewed for patients with primary SCSHN from 1973–2011. Interventions: None Main Outcomes and Measures: Overall survival (OS) and disease-specific survival (DSS). Results: A total of 167 cases of SCSHN were identified. The median age at diagnosis was 37 and 59.9% of patients were males. The mono-phasic spindle cell and biphasic variants were the most common histological subtypes. Surgical resection and radiation therapy were performed in 89.8% and 64.7% of cases, respectively. The median overall survival (OS) at 2, 5, and 10 years was 77%, 66%, and 53%, respectively. Univariate Kaplan-Meier survival analysis revealed that age, race, stage, and size were associated with improved survival. Histological subtype was not associated with significant differences in survival. Radiotherapy was associated with improved disease-specific survival (p=0.003), while surgical management was not associated with improved survival. Multivariate Cox regression analysis revealed that size >5 cm (p=0.007) and stage at presentation (p=0.003) were independent determinants of OS. When separately analyzing cohorts with tumors ≤5 cm and >5 cm, stage at presentation was found to be a significant predictor of survival in both (p=0.003, p=0.010); surgical resection and radiotherapy were not associated with differential survival outcomes using this model. Conclusion and Relevance: SCSHN is an extremely rare malignancy. Independent significant determinants of survival include size >5 cm and stage at presentation. Histological subtype of the tumor is not a significant predictor of survival. Surgical resection and radiation therapy were not found to be independent determinants of survival.

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“…Some studies reported that postoperative dose radiotherapy of 50-65 Gy in patients with clear safety margins or microscopic residual tumor was effective in reducing local recurrence, but not survival, [15][16][17] nor the chemotherapy before or after surgery in two different research works. 17,18 Therefore, surgical resection with safe margins is most important; chemoradiotherapy effectiveness remains uncertain.…”

Section: A B Cmentioning

confidence: 99%

“…1 Predictors of worse prognosis for SS have been proposed, such as diameter >5cm, biphasic type, primary site based skull, bone involvement, and positive margins after surgical resection. 8,15 The causes of death in SS are recurrences and distant metastases (lungs after cervical lymph nodes). Although local control is difficult, it has been improved with the development of new surgical techniques.…”

Section: A B Cmentioning

confidence: 99%

Monophasic Synovial Sarcoma of the Infratemporal Fossa—Case Report and Review of the Literature

Mendoza¹,

Sepúlveda²,

Ayres³

2017

Oncology &Amp; Hematology Review (US)

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Synovial sarcoma (SS) represents about 10% of all soft tissue sarcomas. It is believed that its origin would be found in cells that are related neither to ultrastructural nor to histological features of the synovial tissue. Head and neck is very rarely affected, with the lower extremities being most frequent. Complete resection with or without radiotherapy and chemotherapy is currently considered the best available therapy. This time we present the case of a patient with SS located in the infratemporal fossa, its diagnosis, treatment and evolution. According to our knowledge it is the first reported case in South America.

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Treatment outcomes for patients with synovial sarcoma of the head and neck

Cited by 36 publications

References 12 publications

Primary synovial sarcoma of the parapharyngeal space: a clinicopathologic study of five cases

Primary synovial sarcoma of the parapharyngeal space: a clinicopathologic study of five cases

Factors Associated With Survival in Patients With Synovial Cell Sarcoma of the Head and Neck

Monophasic Synovial Sarcoma of the Infratemporal Fossa—Case Report and Review of the Literature

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