title: Salvage treatment experience in advanced synovial sarcoma: a multicenter retrospective analysis of the Anatolian society of medical oncology.
abstract: BACKGROUND
  We aimed to evaluate prognostic factors and response rates to various treatment approaches to patients with synovial sarcoma in an advanced setting.
  
  
  METHODS
  We retrospectively reviewed the medical records of 55 patients (18 pts; 32.7% women) diagnosed with synovial sarcomas. Twenty had metastatic disease at the time of diagnosis while the remainder of the study group consisted of patients who developed metastatic or inoperable locally advanced disease during follow up.
  
  
  RESULTS
  The median follow up time was 15 months (range: 1-53). Regarding outcomes for the 55 patients, 3 and 5 year overall survival rates were 26% and 14%, respectively. In univariate analyses among demographic factors female gender was associated with a better outcome (p=0.030). Patients with early progressing disease (<2 years) had a worse prognosis when compared to patient group with late relapse, but this difference did not reach statistical significance (p=0.056). According to multivariate Cox regression analysis patients who had undergone metastasectomy had a significant survival advantage (p=0.044). The overall response rate to different salvage chemotherapy regimens given as second line treatment was around 42.9-53.9% for all regimes. There were no statistically significant differences between chemotherapy regimens given in either second or third line settings in terms of overall survival.
  
  
  CONCLUSIONS
  We observed no major differences in terms of response rate and survival between different salvage chemotherapy regimens. Although metastatic disease still carries a poor prognosis, metastasectomy was found to be associated with improved survival.
authors.affiliation: Medical Oncology Department, Namik Kemal University Hospital, Tekirdag, Turkey E-mail : drtarkan1975@gmail.com.
authors.forename: Tarkan
authors.initials: T
authors.lastname: Yetisyigit
authors.forename: Erkan
authors.initials: E
authors.lastname: Arpaci
authors.forename: Erdogan Selcuk
authors.initials: ES
authors.lastname: Seber
authors.forename: Mehmet
authors.initials: M
authors.lastname: Kucukoner
authors.forename: Fatma Tugba
authors.initials: FT
authors.lastname: Kos
authors.forename: Ozlem Uysal
authors.initials: OU
authors.lastname: Sonmez
authors.forename: Suleyman
authors.initials: S
authors.lastname: Alici
authors.forename: Tulay
authors.initials: T
authors.lastname: Akman
authors.forename: Bilge
authors.initials: B
authors.lastname: Aktas
authors.forename: Ramazan
authors.initials: R
authors.lastname: Yildiz
authors.forename: Yusuf
authors.initials: Y
authors.lastname: Gunaydin
authors.forename: Mevlude
authors.initials: M
authors.lastname: Inanc
authors.forename: Umut
authors.initials: U
authors.lastname: Demirci
authors.forename: Necati
authors.initials: N
authors.lastname: Alkis
authors.forename: Mahmut
authors.initials: M
authors.lastname: Gumus
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008495:Medical Oncology; D059146:Metastasectomy; D008875:Middle Aged; D015999:Multivariate Analysis; D009364:Neoplasm Recurrence, Local / Q000628:therapy*; D011379:Prognosis; D016016:Proportional Hazards Models; D011878:Radiotherapy; D012189:Retrospective Studies; D016879:Salvage Therapy / Q000379:methods*; D013584:Sarcoma, Synovial / Q000401:mortality / Q000628:therapy*; D012737:Sex Factors; D012955:Societies, Medical; D015996:Survival Rate; D014421:Turkey; D055815:Young Adult