The present study aimed to describe the distribution and features of the SYT-SSX fusion gene in Chinese patients with
synovial sarcoma (SS), and to analyze the prognostic value of SYT-SSX fusion type and clinicopathological parameters for
tumor-related death, recurrence, and
metastasis in SS.
SYT-SSX1 and
SYT-SSX2 fusion transcripts were tested by reverse transcription-polymerase chain reaction in 141
formalin-fixed,
paraffin-embedded SS. The prognostic implication of SYT-SSX fusion type and clinicopathological parameters were analyzed by univariate and multivariate survival analyses.
SYT-SSX1 and
SYT-SSX2 were detected in 50 (34.5%) and 91 (64.5%)
tumors, respectively.
SYT-SSX1 (risk ratio [RR] = 2.032, P = 0.004), larger
tumor size (RR = 1.859, P = 0.008), and aggressive Fédération Nationale des Centers de Lutte Contre le
Cancer grade (RR = 2.094, P = 0.001) were adverse predictors for disease-specific survival. However, SYT-SSX fusion type was not associated with local recurrence-free survival (P = 0.216). Patients with larger
tumors (RR = 2.071, P = 0.005) and those who received marginal excision (RR = 2.556, P = 0.005) had poor local recurrence-free survival. Besides,
SYT-SSX1 (RR = 1.859, P = 0.037), older age (RR = 1.799, P = 0.040), and aggressive International Union Against
Cancer stage (RR = 3.690, P < 0.001) proved to be adverse prognostic factors for
metastasis-free survival. In conclusion, compared to
SYT-SSX1,
SYT-SSX2 was more frequent in Chinese patients with SS. Moreover,
SYT-SSX1 was an adverse predictor for disease-specific survival and
metastasis-free survival, but had no relation to local recurrence-free survival. In addition, histological grade and
tumor size were also important prognostic factors for SS.