Synovial sarcoma disease characteristics and primary tumor sites differ between patient age groups: a report of the Cooperative Weichteilsarkom Studiengruppe (CWS)



Older age is associated with worse outcome in synovial sarcoma (SS) patients. Differences in disease presentation among distinct age groups, however, are currently unknown.


SS patients < 21 years registered in consecutive CWS trials over the period of 1981–2018 were evaluated. Characteristics were analyzed according to age groups using the Fisher’s exact test.


The study population included 432 SS patients. Disease characteristics differed according to age groups of children (0–12 years, n = 176), adolescents (13–16 years, n = 178), and young adults (17–21 years, n = 78). The proportion of invasive tumors (T2) was significantly higher in older patients: children 33%, adolescents 39% and young adults 54%, p = 0.009805. Similarly, the proportion of tumors > 10 cm was higher (13%, 21%, 31%; p = 0.005657) whereas conversely, the proportion of small tumors < 3 cm was lower in older patients (29%, 24%, 6%; p = 0.000104). The presence of metastases at first diagnosis was also highest in older patients (6%, 10%, 21%, p = 0.000963).

Notably, the proportion of thigh tumors was higher in older patients (p = 0.04173), whereas the proportion of head–neck tumors was lower in older patients (p = 0.08896).


The rates of large, invasive tumors and the presence of metastases are significantly associated with older patient age. Localization to the thigh is more frequent in older patients.


The causes for these variations require further exploration.

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We are indebted to the personnel of all participating institutions and thank all patients, parents, and guardians for their willingness to participate in the CWS-trials. We thank Iris Veit-Friedrich and Erika Hallmen for their excellent data management and Mary Morgan, MD for review of the manuscript.


Supported by the German Childhood Cancer Foundation, Bonn (A2007/13DKS2009.08); German Cancer Aid, Bonn (CWS-86: no. M34/87/Tr1, CWS-91: no. M76/91/Tr2, CWS-96: T9/96/TrI, CWS-2002-P: 50-2721-Tr2); Federal Ministry of Research and Technology, Bonn (CWS-81) and the Förderkreis Krebskranke Kinder e.V. Stuttgart, Germany.

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Correspondence to Monika Scheer.

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Scheer, M., Blank, B., Bauer, S. et al. Synovial sarcoma disease characteristics and primary tumor sites differ between patient age groups: a report of the Cooperative Weichteilsarkom Studiengruppe (CWS). J Cancer Res Clin Oncol (2020).

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  • Synovial sarcoma
  • Soft tissue sarcoma
  • Pediatric sarcoma
  • Age
  • Age dependency