the effect of age on outcome of synovial sarcoma patients a dutch population based study myrella...
TRANSCRIPT
![Page 1: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/1.jpg)
THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS
A DUTCH POPULATION BASED STUDY
Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der GraafMedical Oncology, Radboud University Medical Centre, Nijmegen
![Page 2: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/2.jpg)
Literature
![Page 3: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/3.jpg)
Literature
![Page 4: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/4.jpg)
Research question• Is age an independent prognostic factor for overall
and relative survival in synovial sarcoma patients?
![Page 5: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/5.jpg)
Research question• Is age an independent prognostic factor for overall
and relative survival in synovial sarcoma patients?
• Do treatment modalities explain the differences between variant age groups?
![Page 6: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/6.jpg)
Materials & Methods• The Netherlands Cancer Registry:
• >95% coverage• Information at diagnosis• Tumour and patient characteristics, diagnostics and therapy • Sources: Dutch pathology network (PALGA) & hospital records
![Page 7: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/7.jpg)
Materials & Methods• The Netherlands Cancer Registry:
• >95% coverage• Information at diagnosis• Tumour and patient characteristics, diagnostics and therapy • Sources: Dutch pathology network (PALGA) & hospital records
• Cancer care in the Netherlands• Sarcoma care centralised in recent years
![Page 8: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/8.jpg)
Materials & Methods• The Netherlands Cancer Registry:
• >95% coverage• Information at diagnosis• Tumour and patient characteristics, diagnostics and therapy • Sources: Dutch pathology network (PALGA) & hospital records
• Cancer care in the Netherlands• Sarcoma care centralised in recent years
• Statistics: • Kaplan Meier for Overall survival (OS) • Relative survival (RS)• Univariate analyses• Multivariate Cox regression analyses
![Page 9: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/9.jpg)
Age groups
Children < 18years
Adults35-64years
AYAs18-34years
Elderly≥65years
![Page 10: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/10.jpg)
Patient cohort
438 (75%)
102 (17%)
46 (8%)
Patients histologically diagnosed with SS: 1989-2012
Localized diseaseMetastatic diseaseUnknown
Total: 586 patients
![Page 11: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/11.jpg)
Overall survival: stage at diagnosis
No metastasis 5yr OS: 64±2%
Unknown stage
Metastasesmedian survival: 11±1months
• Median follow up: 42 months (range 0-300 months)
Cum
ulati
ve s
urvi
val
Survival time (months)
![Page 12: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/12.jpg)
Localised disease
![Page 13: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/13.jpg)
Patient characteristicsVariable n = 438 (100%)
Age o <18 yearso 18-34 yearso 35-64 yearso ≥65 years
5114319252
(12%)(33%)(44%)(12%)
Sex o Maleo Female
236202
(54%)(46%)
Histology o Monophasico Biphasico Not specified
9598
245
(22%)(22%)(56%)
Hospital of surgery o General hospitalo Academic hospitalo Unknown
108196134
(25%)(45%)(31%)
![Page 14: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/14.jpg)
Patient characteristicsVariable n = 438 (100%)
Site of origin o Extremitieso Head and necko Trunko Other
294367830
(67%)(8%)
(18%)(7%)
Therapy o Surgery aloneo Surgery + RT (+CT)o Surgery + CTo No surgery
1512063843
(35%)(47%)(9%)
(10%)
Resection status
o R0o R1 / R2o R status unknown
13551
252
(31%)(12%)(58%)
![Page 15: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/15.jpg)
Overall survival: age groups
5yr OS: 91±4% Children
5yr OS: 72±4% AYAs
5yr OS: 57±4% Adults
5yr OS: 43±7% Elderly
Cum
ulati
ve s
urvi
val
Survival time (months)
![Page 16: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/16.jpg)
Relative survival: age groups5yr OS: 91%5yr RS: 91% Children
5yr OS: 72%5yr RS: 72% AYAs
5yr OS: 57%5yr RS: 58% Adults
5yr OS: 43%5yr RS: 53% Elderly
RS: Corrected for age, sex and year
![Page 17: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/17.jpg)
Age as a continous variable
Age (years)
Surv
ival
tim
e (m
onth
s)
![Page 18: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/18.jpg)
Cox regression: Univariate analyses
VariablesAge groups
SexHistology
Hospital of surgerySite of origin
TherapyResection status
![Page 19: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/19.jpg)
Cox regression: Univariate analyses
VariablesAge groups
SexHistology
Hospital of surgerySite of origin
TherapyResection status
p < 0.10
![Page 20: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/20.jpg)
Cox regression: Univariate analyses
VariablesAge groups
SexHistology
Hospital of surgerySite of origin
TherapyResection status
p < 0.10
![Page 21: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/21.jpg)
Cox regression: Univariate analyses
VariablesAge groups
SexHistology
Hospital of surgerySite of origin
TherapyResection status
p < 0.10
![Page 22: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/22.jpg)
Total Children AYAs Adults Elderly0%
10%20%30%40%50%60%70%80%90%
100%
Surgery + CT
Surgery + RT (+CT)
Surgery alone
Treatment modalities*Chi-square: p<0.05
*
43 patients received no surgery left out of multivariate analysis
![Page 23: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/23.jpg)
Cox regression: Multivariate analysis
n HR
Children
AYAsAdults
Elderly
Surgery alone
Surgery + (neo)adj radiotherapy*
Surgery + (neo)adj chemotherapy
Extremities
Head and neck
Trunk
Other
Primary localisation
136 2.26
171 3.81
39 6.52
151 1
206 0.93
38 1.75
279 1
33 1.05
60 1.97
Age groups
Treatment
49 1
23 2.04
![Page 24: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/24.jpg)
Cox regression: Multivariate analysis
Children
AYAsAdults
Elderly
Surgery alone
Surgery + RT (+CT)
Surgery + CT
Extremities
Head and neck
Trunk
Other
Primary localisation
136 2.26
171 3.81
39 6.52
151 1
206 0.93
38 1.75
279 1
33 1.05
60 1.97
Age groups
Treatment
49 1
23 2.04
n HR
![Page 25: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/25.jpg)
Cox regression: Multivariate analysisn HR
ChildrenAYAs
Adults
Elderly
Surgery alone
Surgery + RT (+CT)
Surgery + CT
Extremities
Head and neck
Trunk
Other
Primary localisation
136 2.26
171 3.81
39 6.52
151 1
206 0.93
38 1.75
279 1
33 1.05
60 1.97
Age groups
Treatment
49 1
23 2.04
![Page 26: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/26.jpg)
Take home messages
1. Age at diagnosis is an independent prognostic factor for overall and relative survival
2. Survival differences can not be explained by treatment modalities
![Page 27: THE EFFECT OF AGE ON OUTCOME OF SYNOVIAL SARCOMA PATIENTS A DUTCH POPULATION BASED STUDY Myrella Vlenterie, SEJ Kaal, VKY Ho, R Vlenterie, WTA van der](https://reader036.vdocuments.mx/reader036/viewer/2022081603/5697bfa71a28abf838c98936/html5/thumbnails/27.jpg)
Future research
• Further research in tumor biology is necessary
to explain the survival differences