Treatment of Synovial Sarcoma in Adults (Age 18 Years or Older)

Synovial sarcoma in adult patients presents a persistent clinical challenge. Five-year survival rates in adults with synovial sarcoma have plateaued since the 1980s, with no advances in treatment efficacy, making structured, guideline-concordant management essential.

Clinical Approach

For adult patients with synovial sarcoma, the treatment strategy typically centres on surgery combined with radiation, with neoadjuvant chemotherapy considered in appropriately selected cases depending on lesion characteristics — but the full treatment algorithm, criteria, and sequencing are detailed in the structured protocol.

Complete regimen, eligibility criteria, and sequencing available in the full protocol below.

Instant Access to Structured Evidence-Based Regimens

References

Five-year survival rates in adults with SS have plateaued since the 1980s with no advances in treatment efficacy.
For localized STS, treatment guidelines recommend surgical resection with wide excision with negative margins where possible, combined with radiotherapy (neoadjuvant or adjuvant) for intermediate-high-grade (grades 2-3), deep, >5 cm lesions.
While the ESMO guidelines recommend three cycles of neoadjuvant full-dose anthracycline plus ifosfamide chemotherapy, due to noninferior OS compared with five cycles, treatment recommendations should be made on an individual basis in patients affected by more rare STS histological types.

DOI: 10.1016/j.esmoop.2023.101618

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