Surgical management and outcome of synovial sarcoma in the spine
Abstract Background Synovial sarcoma (SS) is a soft tissue sarcoma that rarely occurs in the spine, and a minimal number of cases have been reported in the literature. Spinal SS is challenging in diagnosis and treatment and has a poor prognosis. The aim of this study was to summarize and analyse the...
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doaj-97a502e71a6640a4b8993b32f3ca29ac2020-11-24T21:40:25ZengBMCWorld Journal of Surgical Oncology1477-78192018-08-0116111110.1186/s12957-018-1471-xSurgical management and outcome of synovial sarcoma in the spineMinglei Yang0Nanzhe Zhong1Chenglong Zhao2Wei Xu3Shaohui He4Jian Zhao5Xinghai Yang6Jianru Xiao7Department of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityDepartment of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityDepartment of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityDepartment of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityDepartment of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityDepartment of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityDepartment of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityDepartment of Orthopedic Oncology, Changzheng Hospital, Second Military Medical UniversityAbstract Background Synovial sarcoma (SS) is a soft tissue sarcoma that rarely occurs in the spine, and a minimal number of cases have been reported in the literature. Spinal SS is challenging in diagnosis and treatment and has a poor prognosis. The aim of this study was to summarize and analyse the clinical features and outcomes of patients with spinal SS. Methods A total of 16 cases of patients with spinal SS admitted to our institution were reviewed retrospectively. General information, radiological findings and treatment strategies were collected. These patients were followed up regarding their continuing treatment, local or distant recurrence and survival. Results Spinal SS patients in this series ranged in age from 12 to 68 years (median, 33). Four en bloc resections and 12 piecemeal resections were performed. Improved Frankel (P = 0.002), visual analogue scale (P = 0.002) and Karnofsky Performance Status (P = 0.002) scores were seen postoperatively. The mean follow-up period was 35.9 ± 23.5 (median 31.5, range 4–87) months, with four local recurrences and three distant metastases detected. Eight patients (50.0%) died of disease by the last follow-up. The 1-, 3- and 5-year overall survival rates were 87.5%, 61.4% and 40.9%, respectively. Preoperative chemotherapy was used in three patients to facilitate surgical resection, and adjuvant chemotherapy and radiotherapy were used in six patients. Conclusions Spinal SS has a relatively high risk of local recurrence and distant metastasis. Surgical intervention can improve the neurological function and relieve pain in these patients. En bloc excision is an effective treatment strategy to improve survival and prevent local recurrence. Management of spinal SS should be under the instruction of a multidisciplinary team.http://link.springer.com/article/10.1186/s12957-018-1471-xSynovial sarcomaSpineSurgeryPrognosis |
collection |
DOAJ |
language |
English |
format |
Article |
sources |
DOAJ |
author |
Minglei Yang Nanzhe Zhong Chenglong Zhao Wei Xu Shaohui He Jian Zhao Xinghai Yang Jianru Xiao |
spellingShingle |
Minglei Yang Nanzhe Zhong Chenglong Zhao Wei Xu Shaohui He Jian Zhao Xinghai Yang Jianru Xiao Surgical management and outcome of synovial sarcoma in the spine World Journal of Surgical Oncology Synovial sarcoma Spine Surgery Prognosis |
author_facet |
Minglei Yang Nanzhe Zhong Chenglong Zhao Wei Xu Shaohui He Jian Zhao Xinghai Yang Jianru Xiao |
author_sort |
Minglei Yang |
title |
Surgical management and outcome of synovial sarcoma in the spine |
title_short |
Surgical management and outcome of synovial sarcoma in the spine |
title_full |
Surgical management and outcome of synovial sarcoma in the spine |
title_fullStr |
Surgical management and outcome of synovial sarcoma in the spine |
title_full_unstemmed |
Surgical management and outcome of synovial sarcoma in the spine |
title_sort |
surgical management and outcome of synovial sarcoma in the spine |
publisher |
BMC |
series |
World Journal of Surgical Oncology |
issn |
1477-7819 |
publishDate |
2018-08-01 |
description |
Abstract Background Synovial sarcoma (SS) is a soft tissue sarcoma that rarely occurs in the spine, and a minimal number of cases have been reported in the literature. Spinal SS is challenging in diagnosis and treatment and has a poor prognosis. The aim of this study was to summarize and analyse the clinical features and outcomes of patients with spinal SS. Methods A total of 16 cases of patients with spinal SS admitted to our institution were reviewed retrospectively. General information, radiological findings and treatment strategies were collected. These patients were followed up regarding their continuing treatment, local or distant recurrence and survival. Results Spinal SS patients in this series ranged in age from 12 to 68 years (median, 33). Four en bloc resections and 12 piecemeal resections were performed. Improved Frankel (P = 0.002), visual analogue scale (P = 0.002) and Karnofsky Performance Status (P = 0.002) scores were seen postoperatively. The mean follow-up period was 35.9 ± 23.5 (median 31.5, range 4–87) months, with four local recurrences and three distant metastases detected. Eight patients (50.0%) died of disease by the last follow-up. The 1-, 3- and 5-year overall survival rates were 87.5%, 61.4% and 40.9%, respectively. Preoperative chemotherapy was used in three patients to facilitate surgical resection, and adjuvant chemotherapy and radiotherapy were used in six patients. Conclusions Spinal SS has a relatively high risk of local recurrence and distant metastasis. Surgical intervention can improve the neurological function and relieve pain in these patients. En bloc excision is an effective treatment strategy to improve survival and prevent local recurrence. Management of spinal SS should be under the instruction of a multidisciplinary team. |
topic |
Synovial sarcoma Spine Surgery Prognosis |
url |
http://link.springer.com/article/10.1186/s12957-018-1471-x |
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