Synovial Sarcoma of Extremities: Evaluation of Prognostic Factors and Clinical Outcomes

Purpose: As synovial sarcoma has a poor prognosis. In this retrospective study we tried to evaluate its clinical outcome and to identify which prognostic factors influence its clinical outcomes. Patients and Methods: This is a retrospective study of patients with synovial sarcoma of extremities between January 2000 and January 2010 at Clinical Oncology Nuclear Medicine, Mansoura University Hospital. Results: Of 74 patients, 44 males (59.5%) and 30 females (40.5%) with a median age of 38 (range;1-69 years). Thirty two (43.2%) had metastasis at the first diagnosis and 42 (56.75%) had only a localized tumor. The 5-year overall survival of all the patients was 37.83%; 66.7% in patients with localized disease and 0% in patients with metastasis at first diagnosis. Forty one patients (55.4%) died of the disease at a median duration of 12 months (range 4-48 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). Conclusion: 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.