Factors Predictive of Survival in Synovial Sarcoma; a Review of the Literature

Sharp SJE and Choong PFM

University of Melbourne, Australia
Department of Orthopaedics, St. Vincent’s Hospital Melbourne, Australia
Department of Surgery, St. Vincent’s Hospital Melbourne, University of Melbourne, Australia

^*Correspondance to: Choong PFM 

 PDF  Full Text Review Article | Open Access

Abstract:

Background: Synovial sarcomas are a rare malignant mesenchymal soft tissue tumour, with generally poor prognosis due to a high degree of local invasiveness and propensity to metastasise. Despite sharing a common translocation signature, tumour behaviour is highly variable with wide heterogeneity in patient outcomes. Limited data exists in the literature regarding prognostic factors and treatment modalities. This review aims to summarise current literature findings to help better prognosticate patients and evaluate treatment modalities.
Methods: A critical literature review of the English language literature from 2000 was conducted utilising MEDLINE (via OVID) software and searching the terms “synovial sarcoma” alone or in combination with “prognosis”, “radiotherapy”, “chemotherapy” and “neoadjuvant therapy”. 331 articles were retrieved; full-text articles specifically evaluating outcomes in synovial sarcoma were included; unavailable full texts (68) case reports (113) and non-synovial sarcoma related (73) articles were excluded. Further articles (20) were identified by cross referencing the bibliographies of relevant papers; in total 97 papers remained eligible for analysis.
Conclusion: Adverse prognostic factors include: increasing age at diagnosis, male gender, increasing tumour size, deep sited tumours, monophasic and poorly differentiated subtypes, increasing necrosis, increasing mitotic activity, higher genomic complexity, non-specialist treatment centre and inadequate margins. New immunohistochemical markers are emerging that may also assist with prognostication. Radiotherapy improves local control and may offer further survival benefits. Chemotherapy should be reserved for high risk patient groups.

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Cite the Article:

Sharp SJE, Choong PFM. Factors Predictive of Survival in Synovial Sarcoma; a Review of the Literature. Clin Oncol. 2016; 1: 1051.