Prognostic factors in Ewing's sarcoma of the foot.

The outcome of treatment and prognostic factors were reviewed in 36 patients who had Ewing's sarcoma of the foot. The tumor was most common in the calcaneus (19 patients) and metatarsals (15 patients). Age, levels of lactate dehydrogenase, degree of anemia, tumor volume, type of surgery, and radiotherapy were not related to prognosis. Females with pain for less than 6 months, fever, high levels of erythrocyte sedimentation rate, and high levels of alkaline phosphatase showed a tendency for a poorer prognosis. The only observed prognostic factors are tumor site and treatment. Patients treated with four-drug neoadjuvant chemotherapy had the best survival. Four patients with metastatic disease at diagnosis died. Fourteen of 32 patients (44%) with localized Ewing's sarcoma were continuously disease-free at an average followup of 7 years.