title: Perioperative radiotherapy is associated with improved survival among patients with synovial sarcoma: A SEER analysis.
abstract: METHODS
  We examined the outcomes of synovial sarcoma (SS) patients in a national database. We identified 1,189 patients from the Surveillance, Epidemiology, and End Results (SEER) database with data on site and extent of surgery. We excluded patients diagnosed before 1990, <18 years, or lacking pathologic confirmation. Using Kaplan-Meier and Cox proportional hazards analyses, we determined predictors of overall (OS) and disease-specific survival (DSS).
  
  
  RESULTS
  The mean age was 41, 49.3% were female, and 82.2% were white. Radiotherapy (RT) was administered to 57.5%. On multivariable analysis, age at diagnosis, sex, race, anatomic site, SEER summary stage, tumor size, surgery type, and RT predicted OS. Similar predictors of DSS were identified. The hazard ratio (HR) for OS was 0.65 (95% CI 0.48-0.88) in favor of RT and 0.62 (95% CI 0.45-0.86) for DSS. Five-year OS improved 8.4 ± 1.0% with RT (P=0.003), and five-year DSS improved 7.7 ± 1.0% with RT (P=0.015).
  
  
  CONCLUSIONS
  In the largest study to date examining the role of RT in synovial sarcoma, we observed that RT was associated with a statistically significant improvement in oncologic outcome among SS patients. These data support the use of RT in the multi-modality treatment of patients with SS.
authors.affiliation: Division of Surgical Oncology, Department of Surgery, Davis Medical Center, University of California, Sacramento, California.
authors.forename: Khatija W
authors.initials: KW
authors.lastname: Naing
authors.forename: Arta M
authors.initials: AM
authors.lastname: Monjazeb
authors.forename: Chin-Shang
authors.initials: CS
authors.lastname: Li
authors.forename: Li-Yuan
authors.initials: LY
authors.lastname: Lee
authors.forename: Anthony
authors.initials: A
authors.lastname: Yang
authors.forename: Dariusz
authors.initials: D
authors.lastname: Borys
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Canter
mesh_terms: D000328:Adult; D000367:Age Factors; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D015999:Multivariate Analysis; D060787:Neoplasm Grading; D044469:Racial Groups; D018714:Radiotherapy, Adjuvant; D018426:SEER Program; D013584:Sarcoma, Synovial / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D012737:Sex Factors; D012983:Soft Tissue Neoplasms / Q000401:mortality* / Q000473:pathology / Q000628:therapy*; D014481:United States / Q000453:epidemiology
keywords: disease specific survival; overall survival; radiation therapy; radical surgery; synovial sarcoma