Outcomes of treatment of synovial sarcoma

Introduction Synovial sarcoma accounts for 5% to 10% of malignant soft-tissue tumours. It occurs more commonly in males. Treatment options include surgery, radiotherapy and chemotherapy with the latter two being used in either an induction or adjuvant fashion. We review the 15-year experience of management of synovial sarcoma patients (2000-2015) referred to the East Midlands Sarcoma Service to allow for 5-year follow-up Methods Patients were identified from histopathology data held at Leicester and Nottingham. Data were stored in a secure Microsoft Excel spreadsheet. Results 97 patients (49 male) were identified, mean age 42 years (range 8 – 83 years); data were incomplete on 3 patients. 51 (53%) arose in the lower limb. Size at presentation was 38 <5cm, 29 5-10cm and 28 >10cm. 50 patients developed metastatic disease (7 presented with metastases) and 15 patients local recurrence over the course of treatment. The majority of patients were treated with surgery as the primary treatment modality although larger tumours received radiotherapy either as induction or adjuvant. Chemotherapy as a curative treatment was only used for small numbers of patients, although was more commonly used palliatively. Discussion Multi-modality treatment for synovial sarcomas is increasingly commonly used with a view to improving oncologic outcomes. In this unselected series of synovial sarcomas over 50% of patients relapse from the disease and appropriate targeting of those at high risk of relapse may offer a therapeutic advantage. Further work on the dataset continues to identify particular risk factors for relapse.