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A Multicenter Retrospective Outcomes Analysis of Patients with Localized Synovial Sarcoma
Stefano Testa1, Maggie Yuxi Zhou2, Brian C Schulte3
1Division of Hematology and Oncology, Beth Israel Deaconess Medical Center, Boston, Massachusetts.
Cancer Research Communications
|May 12, 2026
Summary
Tumor size and location impact localized synovial sarcoma outcomes. Combined chemotherapy and radiotherapy improve survival for large tumors (>10 cm).
Area of Science:
- Orthopedics
- Surgical Oncology
- Medical Oncology
Background:
- Localized synovial sarcoma (SS) is a rare soft tissue sarcoma.
- Identifying prognostic factors is crucial for optimizing treatment strategies.
Purpose of the Study:
- To determine clinicopathologic factors associated with disease-free survival (DFS) and overall survival (OS) in localized SS.
- To evaluate the impact of perioperative chemotherapy and radiotherapy on outcomes.
Main Methods:
- Retrospective review of 248 localized SS patients (2000-2024) from three US centers.
- Kaplan-Meier survival analysis and Cox regression for univariable and multivariable analyses.
- Assessment of demographics, tumor characteristics, and treatment modalities.
Main Results:
- Tumor size significantly correlated with worse DFS and OS (P < 0.001).
- Location (chest wall, trunk, extremities) correlated with improved DFS (P = 0.006).
- Tumor necrosis was associated with worse OS (P = 0.04), while R0 resection margins improved OS (P = 0.002).
- Perioperative chemotherapy or radiotherapy alone did not impact OS/DFS in the entire cohort.
- Combined perioperative chemotherapy and RT improved OS in patients with tumors ≥ 10 cm (P = 0.006).
Conclusions:
- Tumor size, location, margin status, and necrosis are independent prognostic factors in localized SS.
- Combined perioperative chemotherapy and radiotherapy demonstrate a survival benefit for patients with larger tumors (≥ 10 cm).
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