title: Clinical outcomes for patients with synovial sarcoma of the hand.
abstract: OBJECTIVE
  Soft tissue sarcoma of the hand is rare, and one of the most common histological diagnosis is synovial sarcoma. We report the clinical outcomes of patients with synovial sarcoma of the hand and discuss treatment strategies.
  
  
  METHODS
  We reviewed five patients with synovial sarcoma of the hand treated at our institutions from 1983 to 2013. The mean patient age at the time of diagnosis was 36.6 years (range, 20-62 years). Two patients underwent marginal excision after neoadjuvant chemotherapy, followed by radiation therapy, one underwent wide local excision and two received chemotherapy and radiation therapy.
  
  
  RESULTS
  The average duration of follow-up for all patients was 88.2 months (range, 14-218 months). Two patients continuously remained disease free, two experienced local recurrence requiring additional surgery and then showed no evidence of disease, and one who had distant metastasis at diagnosis died of the disease. No patients developed lymph node metastasis. The estimated 5-year overall survival was 80%.
  
  
  CONCLUSIONS
  Our case series suggests that patients with localised synovial sarcoma of the hand may have favourable outcomes. Wide excision or marginal excision, followed by radiation therapy combined with chemotherapy, represent acceptable treatment strategies for synovial sarcoma of the hand. Regional lymph node dissection does not seem to be essential for synovial sarcoma of the hand.
authors.affiliation: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka 565-0871 Japan.
authors.forename: Hidetatsu
authors.initials: H
authors.lastname: Outani
authors.affiliation: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka 565-0871 Japan.
authors.forename: Kenichiro
authors.initials: K
authors.lastname: Hamada
authors.affiliation: Musculoskeletal Oncology Service, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashiknari, Osaka 537-8511 Japan.
authors.forename: Kazuya
authors.initials: K
authors.lastname: Oshima
authors.affiliation: Musculoskeletal Oncology Service, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashiknari, Osaka 537-8511 Japan.
authors.forename: Susumu
authors.initials: S
authors.lastname: Joyama
authors.affiliation: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka 565-0871 Japan.
authors.forename: Norifumi
authors.initials: N
authors.lastname: Naka
authors.affiliation: Musculoskeletal Oncology Service, Osaka Medical Center for Cancer and Cardiovascular Diseases, 1-3-3 Nakamichi, Higashiknari, Osaka 537-8511 Japan.
authors.forename: Nobuhito
authors.initials: N
authors.lastname: Araki
authors.affiliation: Department of Orthopaedic Surgery, Osaka National Hospital, 2-1-14 Hoenzaka, Chuo-ku, Osaka 540-0006 Japan.
authors.forename: Takafumi
authors.initials: T
authors.lastname: Ueda
authors.affiliation: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka 565-0871 Japan.
authors.forename: Hideki
authors.initials: H
authors.lastname: Yoshikawa
keywords: Hand; Hand preservation; Soft tissue sarcoma; Synovial sarcoma