Management of Synovial Sarcoma in a Tertiary Referral Center: A Retrospective Analysis of 134 Patients.

BACKGROUND: Synovial sarcomas (SS) are malignant mesenchymal neoplasms that account for about 10% of all sarcomas. Complete surgical excision is the mainstay of primary treatment for localized disease, but SS have a high tendency for local relapse and metastases. Metastatic disease is commonly treated with systemic chemotherapy. METHODS: We designed a retrospective analysis to describe the clinical presentation, course of treatment, outcome, and prognosis of patients with SS. Univariate and multivariate analyses were performed for potential prognostic factors. RESULTS: We identified 134 patients treated between 1987 and 2018, with a cutoff date of December 2018. Demographics, disease characteristics, treatment, and survival rates were collected and analyzed. The median overall survival (mOS) from the date of diagnosis was 96.7 months. The median progression-free survival was 6.37 months. Disease-free survival was 26 months. Age over 65 years was found to be a prognostic factor with statistically significant value in the univariate analysis regarding mOS (p = 0.015) and mOS after local relapse (p = 0.0228). CONCLUSIONS: Even though our study is limited by the retrospective nature of the analysis, it adds an important amount of clinical data regarding the treatment and outcome of SS.

Retrospective Analysis of Patients with Advanced Liposarcoma in a Tertiary Referral Center.

BACKGROUND: Liposarcoma (LPS) is a common subtype of soft tissue sarcoma. We describe the clinical outcome of patients with advanced LPS treated in a tertiary referral center and explore potential prognostic factors. PATIENTS AND METHODS: We retrospectively reviewed the records of patients with inoperable or metastatic dedifferentiated liposarcoma (DDLPS), myxoid/round cell liposarcoma (MLPS), and pleomorphic liposarcoma (PLPS) diagnosed and/or treated at the University Hospitals Leuven, Leuven, Belgium, between 2000 and 2014. RESULTS: We identified 100 patients with LPS (67 DDLPS, 25 MLPS, and 8 PLPS). Median overall survival from diagnosis of inoperable or metastatic disease was 13.0 months, without substantial variation between histological subtypes. Sixty-seven patients were treated with systemic chemotherapy. The most common first-line chemotherapeutic agents used were doxorubicin (n = 32), doxorubicin + alkylating agent (n = 16), and trabectedin (n = 5). Best response upon first-line treatment was partial/complete response, stable disease, or progressive disease in 17, 25, and 46% of patients, respectively. On multivariate analysis, metastasectomy and objective response or stable disease achieved with first-line chemotherapy were indicators for better overall survival. CONCLUSION: The LPS subtypes analyzed have a poor prognosis and low response rates to chemotherapy. The prognostic factors identified support the concept of offering systemic chemotherapy to patients with inoperable, advanced disease and of considering metastasectomy in eligible patients.