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Clinical outcomes for patients with synovial sarcoma of the hand.

Outani H, Hamada K, Oshima K, Joyama S, Naka N, Araki N, Ueda T, Yoshikawa H - Springerplus (2014)

Bottom Line: No patients developed lymph node metastasis.The estimated 5-year overall survival was 80%.Regional lymph node dissection does not seem to be essential for synovial sarcoma of the hand.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka 565-0871 Japan.

ABSTRACT

Purpose: Soft tissue sarcoma of the hand is rare, and one of the most common histological diagnosis is synovial sarcoma. We report the clinical outcomes of patients with synovial sarcoma of the hand and discuss treatment strategies.

Methods: We reviewed five patients with synovial sarcoma of the hand treated at our institutions from 1983 to 2013. The mean patient age at the time of diagnosis was 36.6 years (range, 20-62 years). Two patients underwent marginal excision after neoadjuvant chemotherapy, followed by radiation therapy, one underwent wide local excision and two received chemotherapy and radiation therapy.

Results: The average duration of follow-up for all patients was 88.2 months (range, 14-218 months). Two patients continuously remained disease free, two experienced local recurrence requiring additional surgery and then showed no evidence of disease, and one who had distant metastasis at diagnosis died of the disease. No patients developed lymph node metastasis. The estimated 5-year overall survival was 80%.

Conclusions: Our case series suggests that patients with localised synovial sarcoma of the hand may have favourable outcomes. Wide excision or marginal excision, followed by radiation therapy combined with chemotherapy, represent acceptable treatment strategies for synovial sarcoma of the hand. Regional lymph node dissection does not seem to be essential for synovial sarcoma of the hand.

No MeSH data available.


Related in: MedlinePlus

Recurrent synovial sarcoma in the dorsum of the hand: case 5. (a) MRI of the tumour showed high intensity on T1 fat sat image, (b) isointensity on a T1 image and (c) high intensity on a T2 image. The mass spanned the third and fourth metacarpal bones.
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Fig2: Recurrent synovial sarcoma in the dorsum of the hand: case 5. (a) MRI of the tumour showed high intensity on T1 fat sat image, (b) isointensity on a T1 image and (c) high intensity on a T2 image. The mass spanned the third and fourth metacarpal bones.

Mentions: Two patients developed local recurrence, and both were treated with unplanned excisions at another hospital. One (Case 1) received repeated marginal excision to avoid hand amputation, followed by radiation therapy, and the other (Case 5) underwent double ray amputation after local recurrence, because the patient already had received radiation therapy and could not undergo marginal excision followed by radiation therapy (Figure 2). In addition, the latter patient developed metastasis to the lung after initial presentation and underwent pulmonary metastasectomy. No patients developed lymph node metastasis.Figure 2


Clinical outcomes for patients with synovial sarcoma of the hand.

Outani H, Hamada K, Oshima K, Joyama S, Naka N, Araki N, Ueda T, Yoshikawa H - Springerplus (2014)

Recurrent synovial sarcoma in the dorsum of the hand: case 5. (a) MRI of the tumour showed high intensity on T1 fat sat image, (b) isointensity on a T1 image and (c) high intensity on a T2 image. The mass spanned the third and fourth metacarpal bones.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4230306&req=5

Fig2: Recurrent synovial sarcoma in the dorsum of the hand: case 5. (a) MRI of the tumour showed high intensity on T1 fat sat image, (b) isointensity on a T1 image and (c) high intensity on a T2 image. The mass spanned the third and fourth metacarpal bones.
Mentions: Two patients developed local recurrence, and both were treated with unplanned excisions at another hospital. One (Case 1) received repeated marginal excision to avoid hand amputation, followed by radiation therapy, and the other (Case 5) underwent double ray amputation after local recurrence, because the patient already had received radiation therapy and could not undergo marginal excision followed by radiation therapy (Figure 2). In addition, the latter patient developed metastasis to the lung after initial presentation and underwent pulmonary metastasectomy. No patients developed lymph node metastasis.Figure 2

Bottom Line: No patients developed lymph node metastasis.The estimated 5-year overall survival was 80%.Regional lymph node dissection does not seem to be essential for synovial sarcoma of the hand.

View Article: PubMed Central - PubMed

Affiliation: Department of Orthopaedic Surgery, Osaka University Graduate School of Medicine, 2-2, Yamada-oka, Suita, Osaka 565-0871 Japan.

ABSTRACT

Purpose: Soft tissue sarcoma of the hand is rare, and one of the most common histological diagnosis is synovial sarcoma. We report the clinical outcomes of patients with synovial sarcoma of the hand and discuss treatment strategies.

Methods: We reviewed five patients with synovial sarcoma of the hand treated at our institutions from 1983 to 2013. The mean patient age at the time of diagnosis was 36.6 years (range, 20-62 years). Two patients underwent marginal excision after neoadjuvant chemotherapy, followed by radiation therapy, one underwent wide local excision and two received chemotherapy and radiation therapy.

Results: The average duration of follow-up for all patients was 88.2 months (range, 14-218 months). Two patients continuously remained disease free, two experienced local recurrence requiring additional surgery and then showed no evidence of disease, and one who had distant metastasis at diagnosis died of the disease. No patients developed lymph node metastasis. The estimated 5-year overall survival was 80%.

Conclusions: Our case series suggests that patients with localised synovial sarcoma of the hand may have favourable outcomes. Wide excision or marginal excision, followed by radiation therapy combined with chemotherapy, represent acceptable treatment strategies for synovial sarcoma of the hand. Regional lymph node dissection does not seem to be essential for synovial sarcoma of the hand.

No MeSH data available.


Related in: MedlinePlus