Synovial sarcoma: The influence of clinicopathological variables on overall survival in a UK population.
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INTRODUCTION: Synovial sarcoma accounts for 5%-10 % of malignant soft-tissue tumours. Curative treatment includes surgery, with radiotherapy and/or chemotherapy. With no specific treatment regimen for synovial sarcoma, the primary aim of this research was to describe the characteristics of a regional synovial sarcoma population in the UK, and to investigate clinicopathological variables associated with overall survival. METHODS: Ninety-four patients with synovial sarcoma from the East Midlands Sarcoma Service database were pseudo anonymised and clinicopathological variables extracted. Kaplan-Meier and Cox regression statistical analyses were used to identify variables affecting overall survival. RESULTS: Mean age at diagnosis was 42 years (range 8-83 years). Over half (n = 50, 53 %) of patients had a tumour in the lower limb. Thirty-seven (39.6 %) had a tumour size of <5 cm. Sixteen (17 %) patients had local recurrence, and under half (n = 40, 43.5 %) developed metastatic disease. Most patients (n = 63, 63 %) were initially treated with surgery. The majority (n = 58, 61.7 %) had a monophasic subtype, and the overall survival of the whole cohort was 83 months (95 % CI 39.1-127.8). Increasing tumour size and distant recurrence (metastasis) had a significantly negative impact on median overall survival (p = 0.0001). Patients who underwent surgery and radiotherapy had a significantly better median overall survival (p = 0.02). Multivariable analysis identified adjuvant radiotherapy (p = 0.039), lower limb tumour (p = 0.033), and tumour size (<5 cm p = 0.006, 5-10 cm p = 0.0001, >10 cm p = 0.013) as significant survival predictors. CONCLUSION: Adjuvant radiotherapy is a novel independent prognostic marker for synovial sarcoma.