Summary
From May 1985 to March 1990, 18 cases of Enneking's stage II synovial sarcoma of the extremities were treated by a combination of surgery and CYVADIC chemotherapy with or without radiotherapy. The average follow up was 34.7 months. The estimated 5-year survival rate was 78.4% and the continuously disease-free 5-year survival rate was 44.4%. The results were improved by adequate surgery or chemotherapy when local recurrence or metastases had developed. The combination of surgery and CYVADIC chemotherapy with or without radiotherapy was considered to be an effective method of treating this tumour.
Résumé
Dix-huit synovialo-sarcomes des extrémités de stade II selon Enneking ont été traités entre mai 1985 et mars 1990 par un traitement combiné de chirurgie et de chimiothérapie associant cyclophosphamide — vincristine — adriamycin — dacarbazine (CYVADIC) en ajoutant ou non une radiothérapie. La chirurgie été une excision large (14 cas) ou une amputation (4 cas). La chimiothérapie par CYVADIC a été administrée en 6 cycles chez tous les patients. La radiothérapie (de 50 à 80 Gy, en moyenne de 62 Gy) a été utilisée chez les 14 patients opérés par excision large et chez 1 patient après amputation. Le suivi moyen des malades est de 34,7 mois avec un minimum d'un an. Le taux de survie estimé à 5 ans (méthode de Kaplan-Meier) est de 78,4% et le taux de patients sans signe de maladie est de 44,4%. La survie sans signe de maladie semble améliorée par une chirurgie ou une chimiothérapie adaptée quand il existe une récidive locale ou des métastases. L'association chirurgie et chimiothérapie par CYVADIC avec ou sans radiothérapie, s'avère une méthode efficace de traitement du synovialo-sarcome des extrémités.
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Lee, SY., Jeon, DG. & Kim, SS. Synovial sarcoma of the extremities. International Orthopaedics 17, 293–296 (1993). https://doi.org/10.1007/BF00181702
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DOI: https://doi.org/10.1007/BF00181702