title: Synovial sarcomas usually metastasize after >5 years: a multicenter retrospective analysis with minimum follow-up of 10 years for survivors.
abstract: 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.
authors: Department of Paediatric Orthopaedics, Children's University Hospital (UKBB) Basel. andreas.krieg@ukbb.ch
authors: A H
authors: AH
authors: Krieg
authors: F
authors: F
authors: Hefti
authors: B M
authors: BM
authors: Speth
authors: G
authors: G
authors: Jundt
authors: L
authors: L
authors: Guillou
authors: U G
authors: UG
authors: Exner
authors: A R
authors: AR
authors: von Hochstetter
authors: M D
authors: MD
authors: Cserhati
authors: B
authors: B
authors: Fuchs
authors: E
authors: E
authors: Mouhsine
authors: A
authors: A
authors: Kaelin
authors: F M
authors: FM
authors: Klenke
authors: K A
authors: KA
authors: Siebenrock
mesh_terms: 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