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Sarcoma
Volume 2011 (2011), Article ID 231789, 7 pages
http://dx.doi.org/10.1155/2011/231789
Research Article

Clinical Features, Treatment, and Outcome in 102 Adult and Pediatric Patients with Localized High-Grade Synovial Sarcoma

1Division of Medical Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada M5G 2M9
2Division of Medical Oncology, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada M5G 1Z5
3Department of Radiation Oncology, Princess Margaret Hospital, University of Toronto, Toronto, ON, Canada M5G 2M9
4University Musculoskeletal Oncology Unit, Division of Orthopaedic Surgery, Department of Surgery, Mount Sinai Hospital, University of Toronto, Toronto, ON, Canada M5G 1Z5
5Department of Orthopedic Surgery, Hospital for Sick Children, University of Toronto, Toronto, ON, Canada M5G 1X8
6Department of Pathology, Mount Sinai Hospital, Toronto, ON, Canada M5G 1Z5
7Division of Hematology/Oncology, Hospital for Sick Children, University of Toronto, 555 University Avenue, Toronto, ON, Canada M5G 1X8

Received 30 August 2010; Revised 1 February 2011; Accepted 15 February 2011

Academic Editor: Ajay Puri

Copyright © 2011 H. Al-Hussaini et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background. There remains controversy on the routine use of chemotherapy in localized SS. Methods. The records of 87 adult (AP) and 15 pediatric (PP) patients with localized SS diagnosed between 1986 and 2007 at 2 centres in Toronto were reviewed. Results. Median age for AP and PP was 37.6 (range 15–76) and 14 (range 0.4–18) years, respectively. 65 ( ) patients had large tumours (>5 cm). All patients underwent en bloc surgical resection resulting in 94 (92.2%) negative and 8 ( ) microscopically positive surgical margins. 72 ( ) AP and 8 ( ) PP received radiotherapy. Chemotherapy was administered to 12 ( ) AP and 13 ( ) PP. 10 AP and 5 PP were evaluable for response to neoadjuvant chemotherapy, with response rate of and , respectively. 5-year EFS and OS was and , respectively, and was similar for AP and PP, In patients with tumors >5 cm, in whom chemotherapy might be considered most appropriate, relapse occurred in 9/19 ( ) with chemotherapy, compared to 17/46 ( ) In those without. Conclusions. Patients with localized SS have a good chance of cure with surgery and RT. Evidence for a well-defined role of chemotherapy to improve survival In localized SS remains elusive.