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Prognostic factors and clinical outcomes in synovial sarcoma of the extremities


Correspondence: Dr Taweechok Wisanuyotin MD, Department of Orthopaedics, Faculty of Medicine, Khon Kaen University, Khon Kaen 40002, Thailand. Email:



To evaluate the clinical outcomes and identify which prognostic factors influence the clinical outcomes of synovial sarcoma patients at a tertiary university hospital in Thailand.


Patients with synovial sarcoma of the extremities between 1997 and 2007 were reviewed from the database of the Musculoskeletal Oncology Unit, Srinagarind Hospital, Khon Kaen University, Khon Kaen, Thailand.


Of 41 patients, 23 males (56%) and 18 females (44%) with a median age of 39 (range, 1–78 years), 18 (44%) had metastasis at the first diagnosis and 23 (56%) had only a localized tumor. The 5-year overall survival of all the patients was 36%; 64% in patients with localized disease and 0% in patients with metastasis at first diagnosis. In all 23 patients (56%) died of the disease at a median duration of 11 months (range 3–47 months). All patients with metastases died at a median 9 months (range 1–41 months). Metastasis at first diagnosis influenced overall survival for patients with synovial sarcoma (P < 0.001). According to a univariate analysis, the significant adverse factors were biphasic histological subtype and an inadequate surgical margin of the definitive surgery (P < 0.05).


Synovial sarcoma is still a disease with a poor prognosis. Distant metastasis at initial diagnosis is a significant adverse prognostic factor for overall survival. A biphasic histological subtype and an inadequate surgical margin are significant adverse prognostic factors in localized synovial sarcoma.