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Archives of Orthopaedic and Trauma Surgery

, Volume 139, Issue 4, pp 443–449 | Cite as

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

  • Munir KhanEmail author
  • Kenneth S. Rankin
  • Radha Todd
  • Emma Lethbridge
  • Craig Gerrand
Orthopaedic Surgery
  • 49 Downloads

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.

Keywords

Synovial sarcoma Chemotherapy Radiotherapy 

Notes

Compliance with ethical standards

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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Copyright information

© Springer-Verlag GmbH Germany, part of Springer Nature 2018

Authors and Affiliations

  • Munir Khan
    • 1
    Email author
  • Kenneth S. Rankin
    • 2
  • Radha Todd
    • 3
  • Emma Lethbridge
    • 3
  • Craig Gerrand
    • 4
  1. 1.Shaheed Zulfiqar Ali Bhutto Medical University/PIMS HospitalIslamabadPakistan
  2. 2.North of England Bone and Soft Tissue Tumour Service, Freeman HospitalNewcastle upon TyneUK
  3. 3.Freeman HospitalNewcastle Upon TyneUK
  4. 4.London Sarcoma Service, Royal National Orthopaedic HospitalStanmoreUK

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