Synovial sarcoma: a review of 33 cases.

Thirty-three patients with synovial sarcoma were studied with respect to age, sex, site, clinical presentation, pathologic findings, and primary surgical treatment. Seventy percent of the patients were in the first three decades of life, and there was a 2:1 male predominance; the overall survival rate was 36%. There was a high local recurrence rate (64%) after simple local excision, and poor survival (27%). While wide local resection gave the best results (50% survival), it also carried a risk of high recurrence. Patients treated by amputation had a 42% survival rate. Thus, it can be concluded that adequate surgical treatment improved survival and reduced the recurrence rates. The lungs were the most common metastatic site, but lymph node metastasis occurred in 27% of the patients, often after tumor recurrence. Favorable prognostic factors included youth (patients younger than 20) and biphasic or epitheloid histologic types.