Background:this study aims to evaluate the survival outcomes of patients suffering from head and neck synovial sarcoma (HNSS), especially in relation to patients with a localized disease at diagnosis.Methods:this retrospective chart review includes 57 patients diagnosed with primary HNSS between 1981 and 2020 who presented with a localized disease at diagnosis. Overall survival (OS) from diagnosis, local recurrence-free survival (LRFS), and metastasis-free survival (MFS) from the end of the primary tumor treatment are estimated. The Kaplan–Meier method, the log-rank test, and the Cox proportional hazards regression are used.Results:the 5-year OS, LRFS, and MFS are estimated at 80.4% (95% CI: 66.6%, 88.9%), 67.7% (95% CI: 50.0%, 80.4%), and 50.6% (95% CI: 34.4%, 64.8), respectively. Compared to patients undergoing surgical resection alone, those receiving radiation therapy (RT) with surgery have better LRFS (HR: 0.03, 95% CI: 0.001, 0.57), and those undergoing neo/adjuvant chemotherapy with surgery and RT have better MFS (HR: 0.10, 95% CI: 0.01, 0.95). Moreover, among the patients with tumors ≥ 4 cm, those subject to neo/adjuvant chemotherapy have significantly better MFS (5-year MFS: 53.2%, 95% CI: 29.0%, 72.5%) than those treated with surgery and RT alone (5-year MFS: 20.0%, 95% CI: 0.8%, 58.2%) (LR-p= 0.003).Conclusions:overall, the prognosis of HNSS patients looks favorable. Perioperative RT significantly improves local control, and perioperative chemotherapy plays a vital role in delaying metastasis formation in patients with primary HNSS when diagnosed with a localized disease. Importantly, we recommend that systemic therapy should be considered for HNSS patients with tumors ≥ 4 cm.
背景：本研究旨在评估头颈部滑膜肉瘤（HNSS）患者的生存结局，尤其关注诊断时为局限性疾病的患者群体。方法：本回顾性病历分析纳入了1981年至2020年间确诊的57例原发性HNSS患者，所有患者在诊断时均为局限性病变。研究评估了从诊断开始的总生存期（OS），以及从原发肿瘤治疗结束后开始的无局部复发生存期（LRFS）和无转移生存期（MFS）。采用了Kaplan-Meier法、时序检验和Cox比例风险回归模型进行分析。结果：5年OS、LRFS和MFS估计值分别为80.4%（95% CI: 66.6%, 88.9%）、67.7%（95% CI: 50.0%, 80.4%）和50.6%（95% CI: 34.4%, 64.8%）。与仅接受手术切除的患者相比，接受手术联合放疗（RT）的患者具有更好的LRFS（HR: 0.03, 95% CI: 0.001, 0.57），而接受手术联合放疗及新辅助/辅助化疗的患者则具有更好的MFS（HR: 0.10, 95% CI: 0.01, 0.95）。此外，在肿瘤≥4 cm的患者中，接受新辅助/辅助化疗者的MFS（5年MFS: 53.2%, 95% CI: 29.0%, 72.5%）显著优于仅接受手术联合放疗者（5年MFS: 20.0%, 95% CI: 0.8%, 58.2%）（时序检验p=0.003）。结论：总体而言，HNSS患者的预后较为乐观。围手术期放疗显著改善了局部控制，而对于诊断时为局限性病变的原发性HNSS患者，围手术期化疗在延缓转移发生方面起着至关重要的作用。重要的是，我们建议对于肿瘤≥4 cm的HNSS患者应考虑进行全身性治疗。
Oncologic Outcomes in Patients with Localized, Primary Head and Neck Synovial Sarcoma
肿瘤(癌症)患者之家