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 Graaf Medical Oncology, Radboud University Medical Centre, Nijmegen

2. Literature

4. Research question Is age an independent prognostic factor for overall and relative survival in synovial sarcoma patients?

5. 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?

6. 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

7. 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

8. 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

9. Age groups Children < 18years Adults 35-64years AYAs 18-34years Elderly ≥65years

10. Patient cohort Total: 586 patients

11. Overall survival: stage at diagnosis No metastasis 5yr OS: 64±2% Unknown stage Metastases median survival: 11±1months Median follow up: 42 months (range 0-300 months) Cumulative survival Survival time (months)

12. Localised disease

13. Patient characteristics Variablen = 438(100%) Age o <18 years o 18-34 years o 35-64 years o ≥65 years 51 143 192 52 (12%) (33%) (44%) (12%) Sex o Male o Female 236 202 (54%) (46%) Histology o Monophasic o Biphasic o Not specified 95 98 245 (22%) (56%) Hospital of surgery o General hospital o Academic hospital o Unknown 108 196 134 (25%) (45%) (31%)

14. Patient characteristics Variablen = 438(100%) Site of origin o Extremities o Head and neck o Trunk o Other 294 36 78 30 (67%) (8%) (18%) (7%) Therapy o Surgery alone o Surgery + RT (+CT) o Surgery + CT o No surgery 151 206 38 43 (35%) (47%) (9%) (10%) Resection status o R0 o R1 / R2 o R status unknown 135 51 252 (31%) (12%) (58%)

15. Overall survival: age groups 5yr OS: 91±4% Children 5yr OS: 72±4% AYAs 5yr OS: 57±4% Adults 5yr OS: 43±7% Elderly Cumulative survival Survival time (months)

16. Relative survival: age groups 5yr 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

17. Age as a continous variable Age (years) Survival time (months)

18. Cox regression: Univariate analyses

19. p < 0.10

20. Cox regression: Univariate analyses p < 0.10

21. Cox regression: Univariate analyses p < 0.10

22. Treatment modalities *Chi-square: p<0.05 * 43 patients received no surgery  left out of multivariate analysis

23. Cox regression: Multivariate analysis

26. 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

27. Future research Further research in tumor biology is necessary to explain the survival differences