Localized synovial sarcoma: A single institutional study of 191 patients with a minimum follow‐up of 5 years for survivors

Abstract

Purpose Factors affecting long‐term outcomes of synovial sarcoma (SS) remain unknown. Here, we aimed to investigate the long‐term oncological outcomes and prognostic factors in a large group of patients with surgically‐treated localized SS. Patients and Methods Between 1980 and 2011, 191 patients (94 males and 97 females) were treated at a single hospital with a minimum follow‐up of 5 years for survivors. The median age was 35 years (range, 3‐80 years), and the median follow‐up period was 83 months (range, 3‐235 months). Results Disease‐specific survival was 76.4% and 60.4% at 5 and 10 years, respectively. Local recurrence occurred in 23 patients at a median of 33 months (range, 6‐158 months), and metastasis occurred in 73 patients at a median of 20 months (range, 2‐166 months). In multivariate analysis, grade 3 tumors sized ≥5 cm were significantly associated with worse survival. Ten patients (5.2%) developed metastasis more than 5 years after surgery. Conclusion Tumor size and grade govern prognosis in surgically‐treated localized SS in long‐term settings. If adequately treated patients have not developed metastases for 5 years after surgery, the risk of subsequently developing metastases was lower than previously reported.

Management of Synovial Sarcoma in a Tertiary Referral Center: A Retrospective Analysis of 134 Patients

“…The lung was the most common site of metastasis, and the median time between SS diagnosis and the occurrence of metachronous metastasis was 18 months. Similar data have been reported, with a median interval of 20 months for occurrence of the first metastasis in patients with localized disease [10, 22].…”

“…Local relapse was found in 31.3% of the cases, with the median interval between diagnosis and the first relapse being 20.1 months. Outani et al [10] reported a local relapse rate of 12% in their patients after a median interval of 33 months. Bianchi et al [22] reported a local relapse rate of 16%.…”

The Long-Term Outcomes of Intensive Combined Therapy of Adult Patients with Localised Synovial Sarcoma

“…Studies from both Surveillance, Epidemiology and End Results (SEER) and NCDB found an overall survival benefit of RT in patients with SaSy undergoing surgery [ 28 , 29 ]. However, two retrospective, single-institution studies demonstrated a significant increase in LRFS with adjuvant RT but no improvement in OS [ 15 , 30 ].…”

“…In retrospective analyses, the following are mentioned among factors negatively affecting the prognosis: large primary tumour size, grade 3 tumour, monophasic subtype, male sex, older age at onset, non-extremity location, SS18–SSX1 fusion and resection R1 [ 2 , 5 , 6 , 11 , 13 , 14 , 15 , 16 ]. The strongest evidence exists for an association between primary tumour size and clinical outcome [ 2 , 3 , 5 , 7 , 11 , 15 , 17 , 18 ]. Wide surgical resection combined with perioperative radiation therapy (RT) is the cornerstone in the treatment of patients with localised SaSy.…”

Data_Sheet_3.CSV

“…Multiple studies have identified a number of preoperative prognostic factors in patients with synovial sarcoma, to include sex, age, histological subtype, differentiation, tumor location, tumor size, and the EOD (12)(13)(14)(15)(16)(17)(18)(19)(20)(21)(22)(23). These clinical manifestations were included in the candidate prognostic factors for the current model.…”