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Surgical excision and not chemotherapy is the most powerful modality in treating synovial sarcoma: the UK’s North East experience

  • Orthopaedic Surgery
  • Published:
Archives of Orthopaedic and Trauma Surgery Aims and scope Submit manuscript

Abstract

Background and purpose

We reviewed our experience of synovial sarcoma to identify factors predictive of local recurrence and overall survival, the impact of chemotherapy and outcomes after surgical excision alone.

Materials and methods

81 patients were treated between 1997 and 2014 of mean age 39 years (8–78). Tumours were in the extremity in 55 (67%). 9 patients presented with metastases and 10 with unresectable disease. Mean follow-up was 3.7 years (SD 3.8). Treatment groups were palliative, surgery only, surgery and radiotherapy, or surgery with chemotherapy (with or without radiotherapy).

Results

Local recurrence-free survival (LRFS) was 73% at 5 years, and 68% at 10 and 15 years. In multivariate analysis, positive surgical margins were an independent predictor of LRFS. Overall survival (OS) was 50% at 5 years for all patients, and 62% at 5 years for those treated with curative intent. Larger tumour size and non-extremity locations were predictors of poorer OS. Patients who had chemotherapy did not have significantly better OS or LRS than others.

Interpretation

These results show that where feasible, curative resection should not be delayed for chemotherapy. Treatment with surgery only can be associated with good outcomes in selected patients with smaller extremity tumours; although our series is small.

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Authors and Affiliations

  1. Shaheed Zulfiqar Ali Bhutto Medical University/PIMS Hospital, Islamabad, Pakistan

    Munir Khan

  2. North of England Bone and Soft Tissue Tumour Service, Freeman Hospital, Newcastle upon Tyne, NE7 7DN, UK

    Kenneth S. Rankin

  3. Freeman Hospital, Newcastle Upon Tyne, UK

    Radha Todd & Emma Lethbridge

  4. London Sarcoma Service, Royal National Orthopaedic Hospital, Stanmore, Middlesex, UK

    Craig Gerrand

Authors
  1. Munir Khan
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  2. Kenneth S. Rankin
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  3. Radha Todd
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  4. Emma Lethbridge
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  5. Craig Gerrand
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Corresponding author

Correspondence to Munir Khan.

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Conflict of interest

We hereby state that “no” financial or personal gains of any kind have been received by any of the authors in preparation of this manuscript. Dr. Munir Khan stating on behalf of all the authors of this manuscript.

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Khan, M., Rankin, K.S., Todd, R. et al. Surgical excision and not chemotherapy is the most powerful modality in treating synovial sarcoma: the UK’s North East experience. Arch Orthop Trauma Surg 139, 443–449 (2019). https://doi.org/10.1007/s00402-018-3059-x

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  • DOI: https://doi.org/10.1007/s00402-018-3059-x

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