title: Distinct Clinical Characteristics of Unplanned Excision in Synovial Sarcoma.
abstract: BACKGROUND
  We aimed to describe the clinical characteristics and outcomes of unplanned excisions of synovial sarcomas.
  
  
  METHODS
  In total, 90 patients with synovial sarcomas in the extremities were retrospectively reviewed. Patients were divided into unplanned excision (n = 38) and planned excision (n = 52) groups. The average follow-up period was 6 years. The clinicopathological characteristics and oncologic outcomes were compared.
  
  
  RESULTS
  The unplanned excision group showed longer duration of symptoms before diagnosis (p = 0.023), smaller lesion dimensions (p = 0.001), superficial location (p = 0.049), and predilection in the upper extremities (p = 0.037). Synovial sarcomas were most commonly misdiagnosed as neurogenic tumors (56%) in the upper extremities or as cystic masses (47%) in the lower extremities. Oncological outcomes, including disease-specific survival, metastasis-free survival, or local recurrence were not significantly different between the 2 groups (p = 0.159, p = 0.444, and p = 0.335, respectively). Repeated unplanned excision (p = 0.012) and delayed re-excision (p = 0.038) were significant risk factors for local recurrence in the unplanned excision group.
  
  
  CONCLUSIONS
  Synovial sarcomas treated with unplanned excision had distinct characteristics. These findings are important for developing diagnostic and therapeutic strategies for synovial sarcoma.
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea. ; Department of Orthopaedic Surgery, Gachon University Gil Hospital, Incheon, Korea.
authors.forename: Eun Seok
authors.initials: ES
authors.lastname: Choi
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Ilkyu
authors.initials: I
authors.lastname: Han
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Hwan Seong
authors.initials: HS
authors.lastname: Cho
authors.affiliation: Orthopaedic Oncology Service, National Cancer Center, Goyang, Korea.
authors.forename: Hyun Guy
authors.initials: HG
authors.lastname: Kang
authors.affiliation: Orthopaedic Oncology Service, National Cancer Center, Goyang, Korea.
authors.forename: June Hyuk
authors.initials: JH
authors.lastname: Kim
authors.affiliation: Department of Orthopedic Surgery, Seoul National University Hospital, Seoul National University College of Medicine, Seoul, Korea.
authors.forename: Han Soo
authors.initials: HS
authors.lastname: Kim
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D013584:Sarcoma, Synovial / Q000175:diagnosis* / Q000601:surgery*; D012983:Soft Tissue Neoplasms / Q000175:diagnosis* / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Magnetic resonance imaging; Oncologic outcomes; Synovial sarcoma