title: Outcome and the effect of age and socioeconomic status in 1318 patients with synovial sarcoma in the English National Cancer Registry: 1985-2009.
abstract: BACKGROUND
  The role of age as a prognostic factor has been examined in single institutional studies and in larger data sets from the SEER database, showing a survival advantage for younger versus adult patients with synovial sarcoma (SS). To further assess the role of age, socioeconomic status and other prognostic factors on outcome for SS, we analysed a contemporary all-age population-based cohort of patients with SS registered in England.
  
  
  METHODS
  The data on 1318 synovial sarcomas diagnosed in England between 1985 and 2009 were retrospectively analysed for incidence, and the effect of age, patient characteristics and deprivation on outcome using both univariate and multivariate analysis.
  
  
  RESULTS
  The incidence of SS increased to 1.4 per million over the time period, the numbers diagnosed in patients under 10 years of age were small. The site or incidence of metastases did not vary between age groups. There were, however, significant differences (p < 0.05) in the 5-year relative survival rates between patients aged 0-19 years and those ≥20 years of age, 76 % and 53 % respectively. Survival was better in localised tumours at an extremity site. In multivariate analysis higher mortality occurred in older patients, non-extremity site, presence of metastases, female adults and a higher deprivation score.
  
  
  CONCLUSIONS
  Synovial sarcoma in children/teenagers compared with adults, have a similar clinical presentation in this population-based series, but a superior outcome. The finding of socioeconomic deprivation affecting outcome in SS needs further exploration in a complete and contemporary dataset, where all prognostic variables are present.
authors: Department of Paediatric Oncology, Royal Manchester Children's Hospital, Oxford Road, Manchester, M13 9WL UK.
authors: Bernadette
authors: B
authors: Brennan
authors: National Cancer Registration and Analysis Service, Public Health England, Birmingham, UK.
authors: Charles
authors: C
authors: Stiller
authors: Department of Orthopaedic Oncology, Royal Orthopaedic Hospital, Birmingham, UK.
authors: Robert
authors: R
authors: Grimer
authors: Knowledge and Intelligence Service West Midlands, Public Health England, Birmingham, UK.
authors: Nicola
authors: N
authors: Dennis
authors: National Cancer Registration and Analysis Service, Public Health England, Birmingham, UK.
authors: John
authors: J
authors: Broggio
authors: Knowledge and Intelligence Service West Midlands, Public Health England, Birmingham, UK.
authors: Matthew
authors: M
authors: Francis
keywords: Age; Social deprivation; Synovial sarcoma