American journal of clinical oncology · 2025
Primary Synovial Sarcoma of the Abdomen and Pelvis.
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Patel Riddhi R, Feit Jonathan, Werling Grace, White Nora M, Bishop Andrew J, Lin Patrick P, Valenzuela Perez Raul F, Lazar Alexander J, Benjamin Robert S, Patel Shreyaskumar R, Ludwig Joseph, Ravi Vinod, Livingston John A, Zarzour Maria A, Conley Anthony, Somaiah Neeta, Araujo Dejka M
Аннотация
OBJECTIVES: Synovial sarcoma (SS) of the abdomen and pelvis is a rare and understudied condition. This study aimed to evaluate survival outcomes, assess calculated versus observed outcomes, and describe radiographic features among patients with localized abdominal/pelvic SS.
METHODS: A retrospective chart review of 58 patients diagnosed with localized abdominal/pelvic SS between 1992 and 2022 was performed. Overall survival (OS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS) were assessed. Sarculator-predicted 5-year OS and disease-free survival (DFS) were compared with observed outcomes.
RESULTS: Twenty-four (41%) patients had tumors located in the extra-abdominal/pelvic region, and 34 (59%) had tumors located in the intra-abdominal/pelvic region. Most of the patients were female (62%). Survival outcomes revealed a median OS: 5.5 years, 5-year OS: 53%, median MFS: 1.5 years, and 5-year MFS: 32%. Patients with intra-abdominal/pelvic tumors had significantly worse MFS than those with extra-abdominal/pelvic tumors (median 1.3 vs. 2.7 y; P =0.023). Larger tumor size (≥5 cm MFS HR: 4.20, 95% CI: 1.48-11.95), poorly differentiated histology (MFS HR: 2.92, 95% CI: 1.13-7.53), and positive/unknown margins (OS HR: 2.96, 95% CI: 1.29-6.78; LRFS HR: 6.61, 95% CI: 1.65-26.50; MFS HR: 2.45, 95% CI: 1.23-4.89) were associated with worse outcomes. Sarculator-predicted and observed 5-year OS (49% vs. 52%) and DFS (30% vs. 26%) were consistent. Imaging features such as cystic changes and calcification were more frequent in larger and monophasic tumors.
CONCLUSIONS: In localized abdomen/pelvic SS patients, tumor size, location, and surgical margins are critical prognostic factors. Sarculator may aid in risk stratification.
METHODS: A retrospective chart review of 58 patients diagnosed with localized abdominal/pelvic SS between 1992 and 2022 was performed. Overall survival (OS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS) were assessed. Sarculator-predicted 5-year OS and disease-free survival (DFS) were compared with observed outcomes.
RESULTS: Twenty-four (41%) patients had tumors located in the extra-abdominal/pelvic region, and 34 (59%) had tumors located in the intra-abdominal/pelvic region. Most of the patients were female (62%). Survival outcomes revealed a median OS: 5.5 years, 5-year OS: 53%, median MFS: 1.5 years, and 5-year MFS: 32%. Patients with intra-abdominal/pelvic tumors had significantly worse MFS than those with extra-abdominal/pelvic tumors (median 1.3 vs. 2.7 y; P =0.023). Larger tumor size (≥5 cm MFS HR: 4.20, 95% CI: 1.48-11.95), poorly differentiated histology (MFS HR: 2.92, 95% CI: 1.13-7.53), and positive/unknown margins (OS HR: 2.96, 95% CI: 1.29-6.78; LRFS HR: 6.61, 95% CI: 1.65-26.50; MFS HR: 2.45, 95% CI: 1.23-4.89) were associated with worse outcomes. Sarculator-predicted and observed 5-year OS (49% vs. 52%) and DFS (30% vs. 26%) were consistent. Imaging features such as cystic changes and calcification were more frequent in larger and monophasic tumors.
CONCLUSIONS: In localized abdomen/pelvic SS patients, tumor size, location, and surgical margins are critical prognostic factors. Sarculator may aid in risk stratification.