The survival and prognosis analysis of synovial sarcoma subtypes: a Surveillance, Epidemiology, and End Results populati
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ORIGINAL PAPER
The survival and prognosis analysis of synovial sarcoma subtypes: a Surveillance, Epidemiology, and End Results population-based analysis Liang Xiong 1,2 & Zhuoyuan Chen 1,2 & You Zhou 1,2 & Hui Li 1,2 & Tao Xiao 1,2,3 Received: 2 April 2020 / Accepted: 3 July 2020 # SICOT aisbl 2020
Abstract Purpose By comparing epidemiologic and prognostic data of synovial sarcoma subtypes, this study aims to clarify the difference in prognosis and risk factors among different synovial sarcoma subtypes. Methods In total, 1692 patients with synovial sarcoma in the USA who were diagnosed during 1975 through 2016 and retrieved from the Surveillance, Epidemiology, and End Results (SEER) program were studied. Results There were statistically significant differences in the distribution of age and race among three synovial sarcoma subtypes, while no major differences in the distribution of sex, tumor stage, and tumour size were found. The highest five and ten year survival rates were found in the biphasic subtype (69%, 60%), followed by the monophasic subtype (59%, 49%), and lowest in the epithelioid subtype (32%, 26%). Age and SEER historic stage were the two demographic factors that found to have statistically significant impact on survival in all subtypes. Radiation was found to be protective in the monophasic subtype (HR 0.61, p < 0.001). Conclusion Among different synovial sarcoma subtypes, the biphasic subtype favoured the best survival, while the epithelioid cell subtype was associated with the worst. Male and black race were independently associated with worse survival only in the monophasic subtype. Radiotherapy could provide significant benefit for patients with the monophasic synovial sarcoma. Keywords Synovial sarcoma . Subtypes . Prognosis . Tumors . SEER database
Introduction Synovial sarcomas (SS) are rare tumors, which most frequently occur in the limbs, representing 5–10% of all soft tissue sarcomas [1–3]. By convention, SS are always regarded as high-grade Level of Evidence III, Retrospective Cohort Study Electronic supplementary material The online version of this article (https://doi.org/10.1007/s00264-020-04708-5) contains supplementary material, which is available to authorized users. * Hui Li [email protected] * Tao Xiao [email protected] 1
Department of Orthopedics, The Second Xiangya Hospital of Central South University, Changsha 410011, Hunan, China
2
Orthopedic Biomedical Materials Engineering Laboratory of Hunan Province, Changsha 410011, Hunan, China
3
Orthopedic Biomedical Materials Institute of Central South University, Changsha 410011, Hunan, China
sarcomas associated with poor prognosis. Previous studies of SS have reported varied patient outcomes with the five year overall survival ranging from 44 to 76% [4, 5]. According to the third edition of the International Classification of Diseases for Oncology (ICD-O), there are three distinct histologic subtypes of SS, including monophasic SS, biphasic SS, and epithelioid cell SS [6]. The monophasic subtype and the biphasic subtype
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