Prognostic factors and clinical outcomes in synovial sarcoma of the extremities.
OBJECTIVE
To evaluate the clinical outcomes and identify which prognostic factors influence the clinical outcomes of synovial sarcoma patients at a tertiary university hospital in Thailand.


METHODS
Patients with synovial sarcoma of the extremities between 1997 and 2007 were reviewed from the database of the Musculoskeletal Oncology Unit, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.


RESULTS
Of 41 patients, 23 males (56%) and 18 females (44%) with a median age of 39 (range, 1-78 years), 18 (44%) had metastasis at the first diagnosis and 23 (56%) had only a localized tumor. The 5-year overall survival of all the patients was 36%; 64% in patients with localized disease and 0% in patients with metastasis at first diagnosis. In all 23 patients (56%) died of the disease at a median duration of 11 months (range 3-47 months). All patients with metastases died at a median 9 months (range 1-41 months). Metastasis at first diagnosis influenced overall survival for patients with synovial sarcoma (P < 0.001). According to a univariate analysis, the significant adverse factors were biphasic histological subtype and an inadequate surgical margin of the definitive surgery (P < 0.05).


CONCLUSIONS
Synovial sarcoma is still a disease with a poor prognosis. Distant metastasis at initial diagnosis is a significant adverse prognostic factor for overall survival. A biphasic histological subtype and an inadequate surgical margin are significant adverse prognostic factors in localized synovial sarcoma.
Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. taweechok@yahoo.com
Taweechok
T
Wisanuyotin
Krisana
K
Radapat
Winai
W
Sirichativapee
Permsak
P
Paholpak
Weerachai
W
Kosuwon
Chat
C
Sumnanoont
Polasak
P
Jeeravipoolvarn
D000293:Adolescent; D000328:Adult; D000368:Aged; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005121:Extremities / Q000473:pathology*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008175:Lung Neoplasms / Q000401:mortality* / Q000556:secondary / Q000628:therapy; D008207:Lymphatic Metastasis; D008297:Male; D008875:Middle Aged; D009364:Neoplasm Recurrence, Local / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D009367:Neoplasm Staging; D011379:Prognosis; D012307:Risk Factors; D013584:Sarcoma, Synovial / Q000401:mortality* / Q000473:pathology / Q000628:therapy; D015996:Survival Rate; D062606:Tertiary Care Centers; D013785:Thailand; D055815:Young Adult