One hundred and thirteen consecutive patients with synovial sarcoma of the extremity or trunk were studied retrospectively. Seventy-six patients had surgery of their primary tumor at our institution (37 elsewhere). Mean follow-up for survivors was 124 (13-302) months. Thirteen developed local recurrence and 62 pulmonary metastases. Increasing surgical margin, adjuvant radiotherapy, and center-based treatment correlated with better local control. Older age, large tumor size and proximal position on the limb correlated with more metastases. Overall 5- and 10-year survival was 68 and 56%, respectively. Age, size, metastasis, metastasis free period and center-based treatment were independently prognostic.