Oncologic Outcomes in Patients with Localized, Primary Head and Neck Synovial Sarcoma

Area of Science:

• Oncology
• Surgical Oncology
• Radiation Oncology

Background:

• Head and neck synovial sarcoma (HNSS) is a rare malignancy.
• Evaluating survival outcomes for localized HNSS is crucial for treatment planning.

Purpose of the Study:

• To assess survival outcomes for patients with primary head and neck synovial sarcoma (HNSS) presenting with localized disease.
• To identify prognostic factors influencing overall survival (OS), local recurrence-free survival (LRFS), and metastasis-free survival (MFS).

Main Methods:

• Retrospective chart review of 57 primary HNSS patients diagnosed between 1981 and 2020.
• Kaplan-Meier method, log-rank test, and Cox regression for survival analysis.
• Estimation of OS, LRFS, and MFS from diagnosis and primary tumor treatment completion.

Main Results:

• Five-year OS, LRFS, and MFS rates were 80.4%, 67.7%, and 50.6%, respectively.
• Radiation therapy (RT) with surgery improved LRFS (HR: 0.03).
• Perioperative chemotherapy with surgery and RT improved MFS (HR: 0.10), particularly for tumors ≥ 4 cm (5-year MFS: 53.2% vs. 20.0%).

Conclusions:

• Head and neck synovial sarcoma (HNSS) generally has a favorable prognosis in localized disease.
• Perioperative RT enhances local tumor control.
• Perioperative chemotherapy is vital for delaying metastasis in HNSS, especially for larger tumors (≥ 4 cm), warranting consideration of systemic therapy.