Nomogram constructions and prognostic analyses for patients with synovial sarcomas resections: A Single Asian Cohort of 179 Cases

Background: Synovial sarcoma (SS) is a relatively rare soft tissue sarcoma. As SS had high potentials of recurrence and metastasis, we designed two nomograms to predict overall survival (OS) and time to recurrence (TTR) for SS patients. Methods: : The data of 179 SS patients underwent curative surgery were extracted from Shanghai Cancer Center, Fudan University. Cox regression analyses were performed to identify independent prognostic factors. Kaplan-Meier curves were used to compare differences in OS and TTR. Nomograms were created using R software and validated by calibration curves and receiver operating characteristic curves. Results: : Kaplan-Meier curves showed that patients with older age, larger tumors, necrosis, vessel infiltration, higher Ki-67, G3 FNCLCC classification and deeper location had shorter OS and TTR than other patients. Multivariate analyses demonstrated that age and tumor size were independent factors for TTR while tumor size and necrosis were independent factors for OS. Five clinicopathological parameters were adopted to build the nomograms for 3- and 5-year OS and TTR. The Area Under Curve of the nomograms at 3- and 5-year OS reached 0.815, 0.84, respectively, while TTR reached 0.766, 0.777, respectively. Calibration curves further demonstrated considerable consistency between the prediction by our nomograms and actual survival. Conclusions: : Age and tumor size were independent factors for TTR while tumor size and necrosis were independent factors for OS. Under such circumstances, we established two accurate and practicable nomograms which could predict 3- and 5-year OS and TTR for SS patients, which might be instructive for modern medical decision-making process.