title: Prognostic implication of SYT-SSX fusion type and clinicopathological parameters for tumor-related death, recurrence, and metastasis in synovial sarcoma.
abstract: The present study aimed to describe the distribution and features of the SYT-SSX fusion gene in Chinese patients with synovial sarcoma (SS), and to analyze the prognostic value of SYT-SSX fusion type and clinicopathological parameters for tumor-related death, recurrence, and metastasis in SS. SYT-SSX1 and SYT-SSX2 fusion transcripts were tested by reverse transcription-polymerase chain reaction in 141 formalin-fixed, paraffin-embedded SS. The prognostic implication of SYT-SSX fusion type and clinicopathological parameters were analyzed by univariate and multivariate survival analyses. SYT-SSX1 and SYT-SSX2 were detected in 50 (34.5%) and 91 (64.5%) tumors, respectively. SYT-SSX1 (risk ratio [RR] = 2.032, P = 0.004), larger tumor size (RR = 1.859, P = 0.008), and aggressive Fédération Nationale des Centers de Lutte Contre le Cancer grade (RR = 2.094, P = 0.001) were adverse predictors for disease-specific survival. However, SYT-SSX fusion type was not associated with local recurrence-free survival (P = 0.216). Patients with larger tumors (RR = 2.071, P = 0.005) and those who received marginal excision (RR = 2.556, P = 0.005) had poor local recurrence-free survival. Besides, SYT-SSX1 (RR = 1.859, P = 0.037), older age (RR = 1.799, P = 0.040), and aggressive International Union Against Cancer stage (RR = 3.690, P < 0.001) proved to be adverse prognostic factors for metastasis-free survival. In conclusion, compared to SYT-SSX1, SYT-SSX2 was more frequent in Chinese patients with SS. Moreover, SYT-SSX1 was an adverse predictor for disease-specific survival and metastasis-free survival, but had no relation to local recurrence-free survival. In addition, histological grade and tumor size were also important prognostic factors for SS.
authors.affiliation: Department of Pathology, Cancer Institute and Hospital, Tianjin, China.
authors.forename: Yan
authors.initials: Y
authors.lastname: Sun
authors.forename: Baocun
authors.initials: B
authors.lastname: Sun
authors.forename: Jian
authors.initials: J
authors.lastname: Wang
authors.forename: Wenjuan
authors.initials: W
authors.lastname: Cai
authors.forename: Xiulan
authors.initials: X
authors.lastname: Zhao
authors.forename: Shiwu
authors.initials: S
authors.lastname: Zhang
authors.forename: Xishan
authors.initials: X
authors.lastname: Hao
mesh_terms: D000328:Adult; D000970:Antineoplastic Agents / Q000627:therapeutic use; D002681:China; D017931:DNA Primers; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D015999:Multivariate Analysis; D009362:Neoplasm Metastasis; D009367:Neoplasm Staging; D016017:Odds Ratio; D015514:Oncogene Proteins, Fusion / Q000032:analysis / Q000235:genetics*; D011237:Predictive Value of Tests; D011379:Prognosis; D012334:RNA, Neoplasm / Q000235:genetics / Q000302:isolation & purification; D012008:Recurrence; D020133:Reverse Transcriptase Polymerase Chain Reaction; D013584:Sarcoma, Synovial / Q000401:mortality / Q000473:pathology* / Q000628:therapy
chemical_list: D000970:Antineoplastic Agents; D017931:DNA Primers; D015514:Oncogene Proteins, Fusion; D012334:RNA, Neoplasm; C116512:SYT-SSX fusion protein