Knee cancer, also called synovialosarcoma or synovial sarcoma, is one of the rarest cancers. What cause? The warning symptoms? Is it deadly? What life expectancy?
knee cancer, or synovialosarcoma, is a very rare cancer. According an article from the Moroccan Journal of Orthopedic and Traumatological Surgery (2020), the synovialosarcoma is an aggressive tumor soft tissues mainly affecting large joints such as the knees. This tumor is associated with a bad prognosis and has a high risk of metastasis. The sports journalist Matthew Lartot And “voice of rugby” of France Télévisions announced has synovialosarcoma of the right knee and announced that he was going to be right leg amputated”for a matter of survival“, in an interview for Noon Olympic on April 23, 2023.
What is knee cancer or synovialosarcoma?
Synovialosarcomas are malignant soft tissue tumors which usually develop in the vicinity of tendons, bursae or joint capsulesin particular to the lower limbs, preferentially at the level of the popliteal fossa of the knee. Synovialosarcoma represents 6 to 10% of soft tissue sarcomas (less than 1,000 cases per year in France), reports theUniversity of Tours citing figures from the World Health Organization.
What are the symptoms of knee cancer?
Synovialosarcoma causes few specific signs and the clinical examination is generally “poor”. The tumor evolves insidiously. This form of cancer could nevertheless be mentioned in front of:
- Unexplained knee painevolving insidiously
- Walking discomfort
- Swelling and ulceration in the knee
- A change in general condition
- Anemia which can testify to the aggressive course of the tumor process
What is the age of onset for knee cancer? Adulthood ?
Synovialosarcomas would be more frequent in adolescents and young adults (15 to 45 years old) with a majority prevalence in man (sex ratio of 3 to 1 in favor of men).
What is his prognosis for survival?
In the scientific literature, the survival rate of a synovialosarcoma is estimated at 55% at 5 yearsreport doctors who published a study on synovialosarcomas in 2014 in the journal National Library of Medicine. In children, the disease-free survival rate varies between 67-75%. They indicate that these tumors are usually of ranking officercharacterized by a high risk of local recurrences and a propensity to form metastases. The doctors of the Trauma-Orthopaedic Service II of theMohamed V Military Instruction Hospital of Rabat in Morocco confirm that the prognosis is burdened by a significant risk of local recurrences (on average 20 to 40% risk of recurrence) and metastases (on average 40 to 70% risk). They detail that 30 to 75% of synovialosarcomas will have, during their evolution, a secondary location in the lungs (lung metastases). Of the lymph node or bone metastases (more rarely) can also be found. “This attack really determines the prognosis by causing the majority of deaths.“, they specify.
| 5-year survival | 10-year survival | |
|---|---|---|
| Grade II-III tumor | 36 – 76% | 20-63% |
| Little differentiated form | 20-30% | 20-30% |
| Tumor size <5 cm | 64% | 64% |
| Tumor size >5 cm | 26% | 26% |
Source : Mark D. Murphey Imaging of Synovial Sarcoma with Radiologic Correlation. X-rays 2006; 26: 1543-1565.
What are the risk factors or causes of synovialosarcoma?
As with most soft tissue sarcomas, the tissue origin of synovialosarcoma is still unknown and the risk factors for this tumor are not clearly establishedspecifies the WHO classification from 2002.
What imaging tests to detect it?
Due to a slow growing (2 to 4 years old), a moderate size (generally < 5cm) and with a sometimes homogeneous and well-defined appearance, the tumor can be wrongly recognized as benign, indicates the University of Tours. Clinical and radiological examination are of little help in the diagnosis of synovialosarcoma. "To the x-ray standard, nearly 50% of tumors are not visible due to their small size and location (peripheral or axial)“, continues the University of Tours. Nevertheless, theMRI although not specific, it is essential to guide the diagnosis (an MRI can show a tumoral process in the tissues and potential bone damage) and must be confirmed by histological examination or surgical biopsy. A assessment of extension may show secondary localizations.
What is the treatment for knee cancer?
According to the study published in the journal National Library of Medicinethe reference treatment for synovialosarcoma is based on the combination of surgery to the radiochemotherapy (combination of radiotherapy and chemotherapy). Surgery is a “wide resection”, which consists of removing a tumor by cutting the area of skin in which it is located, as well as the healthy tissue located in contact with the tumor. In the most severe cases, a amputation and disarticulation of the member may be needed. “The treatment is complex and expensive, requiring the implementation of a multidisciplinary team that combines the skills of radiologist, pathologist, orthopedic surgeon, oncologist, radiotherapist, psychiatrist to analyze, discuss, decide on the course of action and inform the patient in complete transparency“, specify the doctors and authors of the study.
Sources:
– Moroccan Journal of Orthopedic and Traumatological Surgery, 2020
– Control of tumor progression in sarcomas, French Academy of Medicine, 2015
– Outcomes of Limb Synovialosarcoma Treatment, National Library of Medicine, 2014
– WHO: Tumors of uncertain malignant differentiation, University of Tours, 2009