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Area of Science:

  • Oncology
  • Surgical Oncology
  • Medical Oncology

Background:

  • The benefit of adjuvant chemotherapy (AC) for synovial sarcoma (SS) remains controversial.
  • Evaluating the impact of AC on overall survival (OS) after curative resection is crucial.

Purpose of the Study:

  • To assess the impact of adjuvant chemotherapy on overall survival in patients with synovial sarcoma.
  • To determine if AC benefits patients across different stages of synovial sarcoma.

Main Methods:

  • Utilized the National Cancer Data Base (NCDB) for patients with stage I-III SS from 2004-2012.
  • Employed Cox proportional-hazards modeling to identify factors associated with OS, adjusting for AC receipt.

Main Results:

  • Among 544 patients, 131 received AC. AC was not linked to OS in the overall cohort.
  • In stage III SS patients, AC was associated with prolonged OS in both univariate and multivariable analyses (P=0.033).
  • Factors like older age, positive margins, biphasic histology, and adjuvant radiation also impacted OS in stage III patients.

Conclusions:

  • Adjuvant chemotherapy demonstrates a survival benefit for stage III synovial sarcoma patients.
  • The findings suggest a potential for less restricted use of AC in stage III SS, while not supporting its use in lower stages.