オカザキ　ケン   KEN OKAZAKI   岡崎　賢    所属   医学部 医学科（東京女子医科大学病院）    職種   教授・基幹分野長
論文種別	原著
言語種別	英語
査読の有無	査読あり
表題	Clinical analysis of multimodal treatment for localized synovial sarcoma: A multicenter retrospective study.
掲載誌名	正式名：Journal of orthopaedic science : official journal of the Japanese Orthopaedic Association 略　 称：J Orthop Sci ISSNコード：14362023/09492658
掲載区分	国外
巻・号・頁	epub,pp.epub
著者・共著者	HAGIWARA Yoko, IWATA Shintaro, OGURA Koichi, KAWAI Akira, SUGA Michiro, MORIOKA Hideo, HIRUMA Toru, TSUDA Yusuke, KAWANO Hirotaka, YONEMOTO Tsukasa, ISHI Takeshi, OKAZAKI Ken
担当区分	最終著者
発行年月	2021/10
概要	INTRODUCTION:Several prognostic factors for survival in synovial sarcoma have been proposed, but the role of adjuvant chemotherapy and radiotherapy is a matter of debate. The study aim was to clarify the effect of high-dose ifosfamide-containing chemotherapy and adjuvant radiotherapy for patients with localized synovial sarcoma.MATERIALS AND METHODS:Five tertiary musculoskeletal oncology hospitals participated in this retrospective study. The records of the patient diagnosed with synovial sarcoma without metastasis at diagnosis from 1990 to 2011 have been collected and reviewed. Overall, distant failure-free, and local failure-free survivals were calculated, and prognostic factors for each survival were evaluated by performing univariate and multivariate analyses.RESULTS:A total of 162 patients were enrolled in this study with a median follow-up period of 67 months (range, 5-267 months) for all surviving patients. The 5-year overall, distant failure-free, and local failure-free survival rates were 79.7%, 66.3%, and 98.4%, respectively. Univariate analyses demonstrated that high-dose ifosfamide-containing chemotherapy was significantly associated with better overall (p = 0.014) and distant failure-free survival (p = 0.0043) than that of low-dose or no ifosfamide-containing chemotherapy if we analyzed only patients with tumors >5 cm in size. Addition of radiotherapy was not a significant prognostic factor for overall survival in the univariate and multivariate analyses, but it did improve the overall survival of the patients with R1 resection (p = 0.053).CONCLUSION:Patients with localized synovial sarcoma >5 cm in size had better overall and distant failure-free survival after receiving adjuvant chemotherapy containing high-dose ifosfamide comparing to low-dose or no ifosfamide-containing chemotherapy. The addition of adjuvant radiotherapy was beneficial for the patients who received R1 resection. Alternatively, adjuvant radiotherapy could be avoided for patients who
DOI	10.1016/j.jos.2021.09.012
PMID	34756517