Oncological outcomes of patients with localized primary head and neck synovial sarcoma

Head and neck synovial sarcoma (HNSS) is challenging to treat due to its proximity to vital structures. A retrospective study at MD Anderson Cancer Center (Houston, TX) investigated oncological outcomes of HNSS in patients with primary HNSS with localized disease at diagnosis. The 5-year overall survival, local recurrence-free survival, and metastasis-free survival were 80.4% (95% CI 66.6-88.9), 67.7% (50.0-80.4), and 50.6 (34.4-64.8), respectively. Compared to patients undergoing surgical resection alone, those receiving radiation therapy and surgery had better local recurrence-free survival (HR 0.03; 95% CI 0.001-0.57), and patients undergoing (neo)adjuvant chemotherapy with surgery and radiation therapy had better metastasis-free survival (0.10; 0.01-0.95). Among patients with tumors ≥ 4 cm, those subject to (neo)adjuvant chemotherapy plus surgery and radiation therapy had significantly better metastasis-free survival than those treated with surgery and radiation therapy alone (at 5 years 53.2% versus 20.0%; p=0.003). The authors conclude that among patients with localized primary HNSS perioperative radiation therapy improved local control and perioperative chemotherapy delayed metastasis.