title: Synovial sarcoma of the extremities and trunk: a long-lasting disease.
abstract: Synovial sarcoma (SS) of an extremity or trunk is relatively rare and is approached by limb sparing surgery (LSS), radiation therapy (RT) and chemotherapy. We conducted a retrospective analysis of the clinical and histopathological data of 73 patients with proven SS. At a median follow-up time of 6 years, local recurrence was seen in 17.8 and systemic recurrence 35.6% of patients (local-only, 6.8; systemic-only, 24.6; combined, 11%). The 10-year local recurrence-free survival (LRFS), systemic recurrence-free survival (SRFS) and overall survival (OS) rates were 78, 68 and 61%, respectively. LRFS was significantly better in patients treated with isolated limb perfusion (ILP); SRFS was influenced by the delay until diagnosis. The practical aspects of our observations are the need for long-term follow-up in order to diagnose recurrences, the fact that not all local or distant recurrences are necessarily associated with a shortening of OS time and the important role of induction ILP with TNF in cases of extremity SS.
authors.affiliation: National Unit of Orthopedic Oncology, Tel-Aviv Sourasky Medical Center, affiliated with Sackler School of Medicine, Tel-Aviv University, Tel-Aviv 64239, Israel.
authors.forename: A
authors.initials: A
authors.lastname: Gofman
authors.forename: J
authors.initials: J
authors.lastname: Issakov
authors.forename: Y
authors.initials: Y
authors.lastname: Kollender
authors.forename: V
authors.initials: V
authors.lastname: Soyfer
authors.forename: S
authors.initials: S
authors.lastname: Dadia
authors.forename: I
authors.initials: I
authors.lastname: Jiveliouk
authors.forename: G
authors.initials: G
authors.lastname: Flusser
authors.forename: J
authors.initials: J
authors.lastname: Bickels
authors.forename: I
authors.initials: I
authors.lastname: Meller
authors.forename: O
authors.initials: O
authors.lastname: Merimsky
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001132:Arm; D002648:Child; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007866:Leg; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000473:pathology; D012189:Retrospective Studies; D013584:Sarcoma, Synovial / Q000401:mortality / Q000473:pathology* / Q000503:physiopathology*; D016019:Survival Analysis; D013997:Time Factors