Author/Authors :
ALLAM, AYMAN A. King Faisal Specialist Hospital and Research Center (KFSHRC) - Department of Oncology, Saudi Arabia , EL-ENBABY, ASHRAF M. King Faisal Specialist Hospital and Research Center (KFSHRC) - Department of Oncology, Saudi Arabia , EL-SEBAIE, MEDHAT M. King Faisal Specialist Hospital and Research Center (KFSHRC) - Department of Oncology, Saudi Arabia , EL-HUSSEINY, GAMAL King Faisal Specialist Hospital and Research Center (KFSHRC) - Department of Oncology, Saudi Arabia , KHAFAGA, YASSER M. King Faisal Specialist Hospital and Research Center (KFSHRC) - Department of Oncology, Saudi Arabia , EL-WEISHI, AMR King Faisal Specialist Hospital and Research Center (KFSHRC) - Department of Oncology, Saudi Arabia , YOUNGE, DEREK King Faisal Specialist Hospital and Research Center (KFSHRC) - Department of Orthopedic Surgery, Saudi Arabia , MOHAMAD, GAMAL King Faisal Specialist Hospital and Research Center (KFSHRC) - Department of Bio-Statistics, Saudi Arabia , MEMON, MOHAMAD King Faisal Specialist Hospital and Research Center (KFSHRC) - Department of Oncology, Saudi Arabia , SCHULTZ, HENRIK King Faisal Specialist Hospital and Research Center (KFSHRC) - Department of Oncology, Saudi Arabia
Abstract :
Introduction and Objective: Synovial Sarcoma (SS) is a rare type of soft tissue sarcoma that affects mainly the lower extremities of adolescents and young adults. The ideal management of this type of soft tissue sarcoma is still controversial. The purpose of this study is to analyze the variable prognostic factors that may affect the treatment outcome in patients with SS. Patients and Methods: Sixty-six patients with SS (36 males and 30 females) were seen in our institute between January 1985 and December 2000. Median age at diagnosis was 29 years. Lower extremities were the most common site of involvement (43/66 cases; 65%). Patients with stage III and IV disease represented 58% of all patients (38/66). Distant metastases at presentation were reported in 10/66 cases (15%). All patients underwent surgery and adequate resection margins were achieved in 32/66 cases (49%). Radiation therapy was given in 44/66 cases (67%). Chemotherapy was delivered to 11/66 patients (17%). Results: With a median follow up of 50 months, the 5- year overall survival (OS) for all patients was 45%, while the 5-year relapse free survival (RFS) for patients treated with radical intent was 32%. Prognostic factors that significantly affected OS on univariate analysis were tumor size ( 10 cm vs. 10 cm), tumor stage (stages I and II vs. stages III and IV), adequacy of surgical resection and local control. On multivariate analysis, tumor size and local control were the only independent factors that did affect OS. For RFS, sex, tumor size, tumor grade, tumor stage, and adequacy of surgical resection were the prognostic factors of significance on univariate analysis. Tumor stage and sex were the only independent prognostic factors of significance on multivariate analysis. Conclusion: Synovial sarcoma is an aggressive type of soft tissue sarcoma with poor treatment outcome. Tumor size, stage, grade, and adequacy of surgical resection are the main prognostic factors affecting OS and RFS.
