title: Clinicopathologic factors and adjuvant treatment effects on survival in adult head and neck synovial cell sarcoma.
abstract: BACKGROUND
  Synovial cell sarcoma is a rare soft tissue sarcoma. The purpose of this study was to investigate clinicopathologic factors and management on survival in primary synovial sarcoma of the head and neck.
  
  
  METHODS
  We conducted a retrospective case series of medical records. Standard Kaplan-Meier survival analyses and accompanying log-rank tests were used.
  
  
  RESULTS
  Twenty-eight patients were identified. All patients had surgery in attempt to remove the primary lesion. Nine patients received adjuvant radiation therapy, 2 received chemotherapy, and 14 received chemoradiation therapy postoperatively. Metastases on initial presentation and tumor size >4 cm decreased survival. No significant effect on overall survival or local tumor recurrence with histologic subtype, lymph node involvement at diagnosis, tumors >5 cm, or when comparing adjuvant therapy types.
  
  
  CONCLUSIONS
  Although surgery remains the mainstay of treatment, our results do not suggest that adding chemotherapy to postoperative radiotherapy confers a survival or control benefit.
authors.affiliation: Geisel School of Medicine at Dartmouth College, Hanover, New Hampshire.
authors.forename: Matthew G
authors.initials: MG
authors.lastname: Crowson
authors.forename: Ian
authors.initials: I
authors.lastname: Lalich
authors.forename: Michael G
authors.initials: MG
authors.lastname: Keeney
authors.forename: Joaquin J
authors.initials: JJ
authors.lastname: Garcia
authors.forename: Daniel L
authors.initials: DL
authors.lastname: Price
mesh_terms: D000046:Academic Medical Centers; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D017024:Chemotherapy, Adjuvant; D015331:Cohort Studies; D003131:Combined Modality Therapy; D016208:Databases, Factual; D018572:Disease-Free Survival; D005260:Female; D006258:Head and Neck Neoplasms / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D037981:Neck Dissection / Q000379:methods; D009361:Neoplasm Invasiveness / Q000473:pathology; D009367:Neoplasm Staging; D011379:Prognosis; D018714:Radiotherapy, Adjuvant; D012189:Retrospective Studies; D018570:Risk Assessment; D013584:Sarcoma, Synovial / Q000401:mortality / Q000473:pathology* / Q000628:therapy*; D016019:Survival Analysis; D016896:Treatment Outcome
keywords: adjuvant therapy; biphasic; monophasic; soft tissue sarcoma; synovial sarcoma