Synovial sarcoma in children and adolescents: A critical reappraisal of staging investigations in relation to the rate of metastatic involvement at diagnosis

Andrea Ferrari, Gian Luca De Salvo, Odile Oberlin, Michela Casanova, Angela De Paoli, Annie Rey, Véronique Minard, Daniel Orbach, Modesto Carli, Bernadette Brennan, Max M. Vannoesel, Carlo Morosi, Michael C. Stevens, Gianni Bisogno

Research output: Contribution to journalArticle


Background: European protocols for paediatric synovial sarcoma (SS) require that all children routinely undergo chest computed tomography (CT) scanning and bone scanning as initial staging procedures. This study aims to determine the rate of initial metastases in paediatric SS based on specific clinical characteristics, thereby investigating whether these diagnostic procedures are really necessary in all patients. Methods: Data on 258 previously-untreated SS patients 5 cm than for tumours ≤5 cm. Conclusions: Our findings suggest that tumour diameter can be used as a variable for identifying patients at greater risk of metastases and warranting more accurate radiological investigations. Chest CT scanning may improve the accuracy of pulmonary staging over X-ray, but requires different ionising radiation exposures that might have carcinogenic potential: it can be omitted for patients with tumours ≤5 cm. Given the very low risk of bone metastases, bone scans may be recommended only in cases with evidence of lung metastases.

Original languageEnglish
Pages (from-to)1370-1375
Number of pages6
JournalEuropean Journal of Cancer
Issue number9
Publication statusPublished - Jun 2012



  • Bone scan
  • Computed tomography
  • Lung metastases
  • Paediatric sarcoma
  • Radiation exposure
  • Staging
  • Synovial sarcoma

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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