Objective: Patients with advanced sarcomas have a dismal prognosis with few effective therapies. The purpose of this study was to evaluate the efficacy and safety of anlotinib in the treatment of advanced sarcoma and to explore the relationship between adverse events (AEs) and efficacy. Methods: Data from 45 advanced sarcoma patients who received anlotinib monotherapy at Affiliated Cancer Hospital of Zhengzhou University between June 2018 and August 2021 were retrospectively analyzed. According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1, the objective remission rate (ORR) and disease control rate (DCR) were calculated, and the progression free survival (PFS) and treatment-related AEs were recorded and analyzed. Survival analysis was conducted using the Kaplan-Meier survival rates were compared using the Log rank test. Results: Forty patients were treated for more than 1.5 months and received efficacy evaluation. The ORR and DCR after 3 months were 7.5%(3/40) and 80.0%(32/40), respectively. The overall ORR was 2.5%(1/40), the total DCR was 27.5%(11/40), and the median progression-free survival (m-PFS) was 6.70 months; The m-PFS of alveolar soft tissue sarcoma (ASPS) was 10.27 months, which was significantly longer than that of other subtypes of sarcoma (P=0.048). In addition, the DCR of ASPS and synovial sarcoma (SS) was significantly better than that of osteosarcoma (P<0.05). The most common AEs were elevated thyroid stimulating hormone (17.8%, 8/45), anemia (15.6%, 7/45), fatigue (11.1%, 5/45). Five patients developed grade 3 AEs after treatment; The PFS of patients with hand-foot syndrome after treatment was significantly longer than that of patients without hand-foot syndrome (14.10 vs 6.00, P=0.024). Conclusions: The efficacy of anlotinib in the treatment of ASPS and SS is better than that of other subtypes. The PFS in the group with hand-foot syndrome was significantly longer than that of the group without hand-foot syndrome.
Humans ; Hand-Foot Syndrome ; Retrospective Studies ; Sarcoma/drug therapy* ; Sarcoma, Synovial/drug therapy* ; Soft Tissue Neoplasms ; Bone Neoplasms

Objective: Patients with advanced sarcomas have a dismal prognosis with few effective therapies. The purpose of this study was to evaluate the efficacy and safety of anlotinib in the treatment of advanced sarcoma and to explore the relationship between adverse events (AEs) and efficacy. Methods: Data from 45 advanced sarcoma patients who received anlotinib monotherapy at Affiliated Cancer Hospital of Zhengzhou University between June 2018 and August 2021 were retrospectively analyzed. According to Response Evaluation Criteria In Solid Tumors (RECIST) Version 1.1, the objective remission rate (ORR) and disease control rate (DCR) were calculated, and the progression free survival (PFS) and treatment-related AEs were recorded and analyzed. Survival analysis was conducted using the Kaplan-Meier survival rates were compared using the Log rank test. Results: Forty patients were treated for more than 1.5 months and received efficacy evaluation. The ORR and DCR after 3 months were 7.5%(3/40) and 80.0%(32/40), respectively. The overall ORR was 2.5%(1/40), the total DCR was 27.5%(11/40), and the median progression-free survival (m-PFS) was 6.70 months; The m-PFS of alveolar soft tissue sarcoma (ASPS) was 10.27 months, which was significantly longer than that of other subtypes of sarcoma (P=0.048). In addition, the DCR of ASPS and synovial sarcoma (SS) was significantly better than that of osteosarcoma (P<0.05). The most common AEs were elevated thyroid stimulating hormone (17.8%, 8/45), anemia (15.6%, 7/45), fatigue (11.1%, 5/45). Five patients developed grade 3 AEs after treatment; The PFS of patients with hand-foot syndrome after treatment was significantly longer than that of patients without hand-foot syndrome (14.10 vs 6.00, P=0.024). Conclusions: The efficacy of anlotinib in the treatment of ASPS and SS is better than that of other subtypes. The PFS in the group with hand-foot syndrome was significantly longer than that of the group without hand-foot syndrome.
Humans ; Hand-Foot Syndrome ; Retrospective Studies ; Sarcoma/drug therapy* ; Sarcoma, Synovial/drug therapy* ; Soft Tissue Neoplasms ; Bone Neoplasms

Primary pulmonary synovial sarcoma is a rare pulmonary malignant tumor originated from primitive mesenchymal, which has short overall survival and poor prognosis. Related case reports are lacked at home and abroad. In recent years, the development of targeted therapy has brought remarkable benefits to cancer patients. Apatinib (Hengrui Pharmaceutical Co. Ltd, Jiangsu, People's Republic of China) is a small molecule vascular endothelial growth factor receptor 2 (VEGFR-2) inhibitor, which selectively inhibits VEGFR-2 and blocks the VEGF signal pathway, then strongly inhibiting the tumor angiogenesis. Apatinib has shown favorable therapeutic effect and acceptable toxicity on various tumors. Here we report a case of primary pulmonary synovial sarcoma with postoperative multiple metastases treated with apatinib, in order to provide a new considerable treatment.
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Humans ; Lung Neoplasms ; drug therapy ; pathology ; surgery ; Male ; Middle Aged ; Neoplasm Metastasis ; Postoperative Period ; Pyridines ; therapeutic use ; Sarcoma, Synovial ; drug therapy ; pathology ; surgery

PURPOSE: Synovial sarcoma is an uncommon malignant soft tissue tumor mostly prevalent in young adults. Previous studies analyzing the prognostic factors have been limited due to the inclusion of heterogenous cohorts of patients with nonextremity and recurrent tumors. The purpose of this study was to determine the independent prognostic factors for the treatment methods associated with local recurrence and metastasis of primary synovial sarcoma localized to the extremities. MATERIALS AND METHODS: Between April 1999 and June 2014, a total of 79 patients were diagnosed with synovial sarcoma, of which 73 underwent wide excision at Kosin University Gospel Hospital and were followed-up for 60 months (24-72 months). The analyzed prognostic factors were treatment methods for local recurrence and metastasis during the postoperative follow-up period. The Cox regression model was used for multivariate analysis. RESULTS: For local recurrence according to the treatment methods, 9 recurrences occurred in 9 surgical treatments, 8 in 20 chemotherapy added surgical treatments, 13 in 20 radiotherapy added surgical treatments, and 4 in 24 chemotherapy with radiotherapy added surgical treatments. For metastasis according to the treatment methods, 9, 5, 12, and 2 metastases occurred respectively. Chemotherapy had statistical significance in multivariate analysis (p<0.0001). CONCLUSION: Adjuvant chemotherapy can be useful for the treatment of synovial sarcoma.
Chemotherapy, Adjuvant ; Cohort Studies ; Drug Therapy ; Extremities* ; Follow-Up Studies ; Humans ; Multivariate Analysis ; Neoplasm Metastasis ; Neoplasm Recurrence, Local ; Radiotherapy ; Recurrence ; Sarcoma, Synovial* ; Survival Rate ; Young Adult

OBJECTIVETo determine the independent prognostic factors of primary synovial sarcoma.

METHODSThe clinical data of 52 patients followed up from 66 patients with synovial sarcoma treated between September 1997 and September 2008 was analyzed retrospectively. There were 28 male and 24 female patients aged from 11 to 71 years old. Three and five-year overall survival (OS), recurrence rate and 9 prognostic factors were analyzed in this study. Univariate and multivariate analysis were performed to determine the prognostic factors of OS.

RESULTSFifty-two patients were followed up with the follow-up time ranged from 6 to 88 months (median 32 months). The 3-, 5-year overall survival rate and local recurrence rate were 52.8%, 30.3% and 32.7% respectively. Univariate showed tumor size < 5 cm, tumor located at extremities, adequate surgical margin and radical resection combined with radiotherapy had better survival rate (P < 0.05). Multivariate analysis demonstrated that tumor size, primary site and adequate surgical margin were independent prognostic factors for OS. Patients received radical resection combined with radiotherapy have longer median relapse time (25 months) compared with marginal resection combined with radiotherapy (18 months) and single radical resection (12 months). Thirty-five (67%) patients were treated with chemotherapy and seventeen (33%) patients received no chemotherapy for the primary tumor. Treatment with chemotherapy was not associated with an improved OS (P = 0.52).

CONCLUSIONSThe independent prognostic factors of synovial sarcoma are tumor size, primary site and adequate surgical margin. Doxorubicin and ifosfamide based chemotherapy was not associated with an improved OS in patients with synovial sarcoma. Radical resection combined with radiotherapy can best control local condition.

Adolescent ; Adult ; Aged ; Antineoplastic Agents ; therapeutic use ; Child ; Female ; Follow-Up Studies ; Humans ; Kaplan-Meier Estimate ; Male ; Middle Aged ; Multivariate Analysis ; Neoplasm Recurrence, Local ; Prognosis ; Regression Analysis ; Retrospective Studies ; Sarcoma, Synovial ; diagnosis ; drug therapy ; radiotherapy ; surgery ; Young Adult

Radiation recall dermatitis is the development of an inflammatory reaction throughout an area previously irradiated, precipitated by the administration of certain drugs. A 48-year-old woman was postoperatively treated with radiotherapy for synovial sarcoma on her left hip. The total dose given was 46 Gy by 2 Gy per day. After 2 weeks, she underwent her 1st cyclophosphamide, dacarbazine, doxorubicin (MAID) chemotherapy teatment. After 3 days, erythema began to develop in the previously irradiated area and during the following 7 days a severe skin and subcutaneous reaction occurred. After 3 weeks, the skin lesion was completely healed and thereafter no further "recall" occurred despite a 2nd MAID chemotherapy treatment.
Cyclophosphamide ; Dacarbazine ; Doxorubicin ; Drug Therapy ; Erythema ; Female ; Hip ; Humans ; Middle Aged ; Radiodermatitis* ; Radiotherapy ; Sarcoma, Synovial ; Skin

Synovial Sarcoma is the fourth most common sarcoma, accounting for 8-10 % of all sarcomas. Synovial sarcoma is highly malignant tumor of mesenchymal origin but rarely occurres in head and neck area. Less than 100 cases of synovial sarcoma occurring in head and neck area have been reported all over the world. Pathologically, there is two type of synovial sarcoma: monophasic variant is composed of only one cell type and "classic" (biphasic) synovial sarcoma has two cellular component, a spindle cell(fibrosarcoma-like) component and a pseudoepithelioma component. Recommended treatment is wide resection with negative margins. The role of chemotherapy and radiation therapy is controversial. We experienced a 42-year-old male patient with slowly enlarging, deep seated mass on right cheek. In the first operation, we suggested that the mass maybe benign tumor. But, initial excisional biopsy specimen of the primary lesion was consistent with synovial sarcoma. The final diagnosis was monophasic synovial sarcoma which was composed of spindle cells. Radical resection was performed two months later because remnant tumor was found on follow up MRI. No further treatment was done. There were no recurrence or metastasis on follow up MRI, chest CT and whole body bone scan after 15 months. This is a report of a rare case of synovial sarcoma of the face with a literature review.
Adult ; Biopsy ; Cheek ; Diagnosis ; Drug Therapy ; Follow-Up Studies ; Head ; Humans ; Magnetic Resonance Imaging ; Male ; Neck ; Neoplasm Metastasis ; Recurrence ; Sarcoma ; Sarcoma, Synovial* ; Tomography, X-Ray Computed

Synovial sarcoma is a malignant soft tissue tumor originated from primitive mesenchymal cell and displays epithelial differentiation. Synovial sarcoma most commonly occurs in the peri-articular regions of the extremities in adolescents and young adults. But primary synovial sarcoma of the pleura is extremely rare. The present report describes a case of primary synovial sarcoma of the pleura in a 35-year-old male who showed unilateral spontaneous hemothorax as initial manifestation. The tumor mass was removed by open thoracotomy. The tumor was composed of oval to spindle cells with abundant vascular structures. Some of the spindle-shaped tumor cells express cytokeratin. A diagnosis of monophasic fibrous synovial sarcoma was made by histologic and immunologic features. The patient received chemotherapy postoperatively and showed no evidence of recurrence or tumor at other sites 1 year after surgery.
Adolescent ; Adult ; Diagnosis ; Drug Therapy ; Extremities ; Hemothorax ; Humans ; Keratins ; Male ; Pleura* ; Recurrence ; Sarcoma ; Sarcoma, Synovial* ; Thoracotomy ; Young Adult

We experienced a case of primary renal synovial sarcoma in a 32 year-old woman. On admission, she complained of intermittent abdominal pain. On radiologic examination, a 12 X 10 cm-sized soft tissue mass was detected on the left kidney. The tumor had histologic and immunophenotypic features that were consistent with spindle cell type monophasic synovial sarcoma. Four months after complete resection of the tumor, a unilateral hematogenous metastasis developed in the lung. She was treated with combined chemotherapy of doxorubicin and ifosfamide every four weeks, and complete remission was achieved. We herein describe the case with a brief review.
Adult ; Antineoplastic Combined Chemotherapy Protocols/*therapeutic use ; Doxorubicin/administration & dosage ; Female ; Human ; Ifosfamide/administration & dosage ; Kidney Neoplasms/diagnosis/*surgery ; Lung Neoplasms/diagnosis/*drug therapy/*secondary ; Remission Induction ; Sarcoma, Synovial/diagnosis/*drug therapy/*secondary/surgery

PURPOSE: The object of the current study was to evaluate the long term survival of synovial sarcoma and to find an appropriate treatment strategy with a favorable prognosis. MATERIALS AND METHODS: Between August 1985 and June 2000, fifty nine synovial sarcoma patients without metastasis at presentation were analyzed and followed for 50.9 (8-161) months. Kaplan-Meier plots were used for survival analysis. Analyzed prognostic factors were sex, age, stage, location, surgical margin, chemotherapy, radiation therapy, local recurrence and metastasis. The log-rank test was used for univariate analysis and the Cox regression model for multivariate analysis. RESULTS: Fourteen-year actual and continuous disease free survivals (ADF/CDF) were 56.4 and 49.7%, respectively. CDF of stage I-IIa and IIb-III were 53.6 and 43.2%, respectively (p=0.55). For local recurrence according to surgical margin, 4 recurrences occurred in 44 wide margins, 1 recurrence in 6 marginal margins, and 1 recurrence in 2 intralesional margins. Among 10 cases of local recurrence, 4 cases had metastasis. Local recurrence, metastasis, and surgical margin had statistical significance in the univariate (p< 0.0001, p<0.0001, p=0.011) and multivariate analysis. CONCLUSION: Fourteen year CDF survival was 49.7%. The alleviation of local recurrence and metastasis is essential for long term survival. In the current study, the only factor under our control was surgical margin. A well designed surgical approach will reduce the recurrence rate.
Drug Therapy ; Humans ; Multivariate Analysis ; Neoplasm Metastasis ; Prognosis ; Recurrence ; Sarcoma, Synovial*