Synovial Sarcoma: Epidemiology, Prognosis, and Imaging in a Tertiary Referral Centre

Full Article

KH Tsang, WSW Chan, MK Chan, KC Lai, ACL Chan

Hong Kong J Radiol 2016;19:19-27

DOI: 10.12809/hkjr1615298

Objectives: To review the disease pattern of synovial sarcoma in a tertiary sarcoma centre in Hong Kong.

Methods: Patients with a histological diagnosis of synovial sarcoma from June 2000 to June 2014 were recruited. Patient data were collected using the electronic Patient Record System and available images were reviewed using the Picture Archiving and Communication System. Kaplan-Meier analysis was performed for overall survival. Multivariate Cox regression was performed to evaluate potential prognostic factors.

Results: A total of 45 consecutive patients with a mean age of 39 years and male-to-female ratio of 1:1.05 were recruited. Tumours were evident in the lower extremities in 28 (62%) cases, in the upper extremities in four (9%), and elsewhere in 13 (29%). The mean duration of symptoms to diagnosis was 1.5 years. The mean tumour size was 7.0 cm. Metastatic disease was present in 11 (24%) patients at initial diagnosis. The most common site of metastasis was the lung. Nineteen patients died of synovial sarcoma during follow-up. The median survival time was 7.5 years. Tumour size of >5 cm (hazard ratio [HR] = 10.06; 95% confidence interval [CI], 1.30-78.15; p = 0.027) and presence of metastasis at diagnosis (HR = 5.56; 95% CI, 1.20-25.77; p = 0.028) were significant adverse prognostic factors after adjustment for age, gender, tumour location, histological subtypes, and adjuvant therapy.

Conclusion: Tumour size of >5 cm and presence of metastasis at diagnosis were identified as adverse prognostic factors.









結果:共45名患者被納入研究範圍,平均年齡39歲,男女比例為1:1.05。28例(62%)腫瘤在下肢,4例(9%)在上肢,13例(29%)在其他部位。從出現症狀至確診的時間平均為1.5年。平均腫瘤大小7.0 cm。11例(24%)的患者在初次診斷時已發現有轉移。肺是最常見的轉移部位。隨訪期間19例因滑膜肉瘤死亡;患者中位生存期7.5年。調整年齡、性別、腫瘤部位、病理類型和輔助治療後顯示腫瘤大於5 cm(風險比 = 10.06;95%置信區間1.30-78.15;p = 0.027)以及初次診斷時有轉移現象(風險比 = 5.56;95%置信區間1.20-25.77;p = 0.028)為顯著不良預後因素。

結論:滑膜肉瘤大於5 cm以及初次診斷時有轉移現象均是不良預後因素。