Synovial sarcomas usually metastasize after >5 years: a multicenter retrospective analysis with minimum follow-up of 10 years for survivors.
BACKGROUND
Synovial sarcoma (SS) is a malignant soft tissue sarcoma with a poor prognosis because of late local recurrence and distant metastases. To our knowledge, no studies have minimum follow-up of 10 years that evaluate long-term outcomes for survivors.


METHODS
Data on 62 patients who had been treated for SS from 1968 to 1999 were studied retrospectively in a multicenter study. Mean follow-up of living patients was 17.2 years and of dead patients 7.7 years.


RESULTS
Mean age at diagnosis was 35.4 years (range 6-82 years). Overall survival was 38.7%. The 5-year survival was 74.2%; 10-year survival was 61.2%; and 15-year survival was 46.5%. Fifteen patients (24%) died of disease after 10 years of follow-up. Local recurrence occurred after a mean of 3.6 years (range 0.5-14.9 years) and metastases at a mean of 5.7 years (range 0.5-16.3 years). Only four patients were treated technically correctly with a planned biopsy followed by a wide resection or amputation. Factors associated with significantly worse prognosis included larger tumor size, metastases at the time of diagnosis, high-grade histology, trunk-related disease, and lack of wide resection as primary surgical treatment.


CONCLUSIONS
In SS, metastases develop late with high mortality. Patients with SS should be followed for >10 years.
Krieg
A H
AH
Department of Paediatric Orthopaedics, Children's University Hospital (UKBB) Basel. andreas.krieg@ukbb.ch
Hefti
F
F
Speth
B M
BM
Jundt
G
G
Guillou
L
L
Exner
U G
UG
von Hochstetter
A R
AR
Cserhati
M D
MD
Fuchs
B
B
Mouhsine
E
E
Kaelin
A
A
Klenke
F M
FM
Siebenrock
K A
KA
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009362:Neoplasm Metastasis; D009364:Neoplasm Recurrence, Local; D012189:Retrospective Studies; D013584:Sarcoma, Synovial / Q000473:pathology*; D017741:Survivors; D055815:Young Adult