Dr. Dhir on Risk-Based Stratification in Epithelioid and Synovial Sarcoma

Aditi Dhir, MD, a clinical assistant professor of the Department of Pediatrics, Division of Hematology/Oncology at Sylvester Comprehensive Center, University of Miami Health System, discusses risk-based stratification in patients with epithelioid and synovial sarcoma.

Similar to most sarcomas, a multimodal approach is often utilized in the treatment of patients with epithelioid and synovial sarcoma, Dhir explains. However, the standard-of-care treatment is a wide surgical resection of the tumor with negative margins, Dhir says.

Treatment is often based on risk stratification. For example, the Children's Oncology Group organized the non-randomized ARST0332 trial, which utilized a risk stratification approach for treating pediatric patients. Patients were classified as being low or high risk, based on whether their tumor was resectable, whether they had any metastases, as well as the grade and size of their tumor, Dhir adds.

For low-risk patients, surgery alone is often a viable treatment option, according to Dhir. However, due to the high rate of local recurrence and metastases for patients with epithelioid and synovial sarcoma, systemic therapy in the form of radiation therapy or chemotherapy is often needed, Dhir concludes.