PURPOSE: To evaluate the importance of surgical margins for local and systemic control of Ewing's sarcoma family tumors (ESFT). METHODS AND MATERIALS: Between 1979 and 1999, 512 patients with ESFTs entered 4 different adjuvant and neoadjuvant studies performed at a single institution. Of these patients, 335 were treated with surgery alone (196) or surgery followed by radiotherapy at doses of 44.8 Gy (139). We compared their outcome with that of the 177 patients who were locally treated by radiotherapy at 60 Gy. RESULTS: Local control (88.8% vs. 80.2%, p < 0.009) and 5-year disease-free survival (63.8% vs. 47.6%, p < 0.0007) were significantly better in patients treated with surgery and, among them, in those with adequate surgical margins (96.6% vs. 71,7%, p < 0.0008, and 69.6% vs. 46.3%, p < 0.0002). Nonetheless, better results were observed only in extremity tumors. CONCLUSIONS: Surgery is better than radiotherapy in cases of extremity ESFT with achievable adequate surgical margins, and in cases of inadequate surgical margins, adjuvant reduced-dose radiotherapy is ineffective. Therefore, when inadequate margins are expected, patients are better treated with full-dose radiotherapy from the start.
PURPOSE: To evaluate the importance of surgical margins for local and systemic control of Ewing's sarcoma family tumors (ESFT). METHODS AND MATERIALS: Between 1979 and 1999, 512 patients with ESFTs entered 4 different adjuvant and neoadjuvant studies performed at a single institution. Of these patients, 335 were treated with surgery alone (196) or surgery followed by radiotherapy at doses of 44.8 Gy (139). We compared their outcome with that of the 177 patients who were locally treated by radiotherapy at 60 Gy. RESULTS: Local control (88.8% vs. 80.2%, p < 0.009) and 5-year disease-free survival (63.8% vs. 47.6%, p < 0.0007) were significantly better in patients treated with surgery and, among them, in those with adequate surgical margins (96.6% vs. 71,7%, p < 0.0008, and 69.6% vs. 46.3%, p < 0.0002). Nonetheless, better results were observed only in extremity tumors. CONCLUSIONS: Surgery is better than radiotherapy in cases of extremity ESFT with achievable adequate surgical margins, and in cases of inadequate surgical margins, adjuvant reduced-dose radiotherapy is ineffective. Therefore, when inadequate margins are expected, patients are better treated with full-dose radiotherapy from the start.
Authors: Selmin Ataergin; Ahmet Ozet; Luis Solchaga; Mustafa Turan; Murat Beyzadeoglu; Kaan Oysul; Fikret Arpaci; Seref Komurcu; Serdar Surenkok; Mustafa Ozturk Journal: Med Oncol Date: 2008-11-07 Impact factor: 3.064
Authors: Wesley Hsu; Thomas A Kosztowski; Hasan A Zaidi; Michael Dorsi; Ziya L Gokaslan; Jean-Paul Wolinsky Journal: Curr Treat Options Oncol Date: 2009-06-23
Authors: Steven G DuBois; Mark D Krailo; Mark C Gebhardt; Sarah S Donaldson; Karen J Marcus; John Dormans; Robert C Shamberger; Scott Sailer; Richard W Nicholas; John H Healey; Nancy J Tarbell; R Lor Randall; Meenakshi Devidas; James S Meyer; Linda Granowetter; Richard B Womer; Mark Bernstein; Neyssa Marina; Holcombe E Grier Journal: Cancer Date: 2014-09-23 Impact factor: 6.860
Authors: Armin Arshi; Justin Sharim; Don Y Park; Howard Y Park; Hamed Yazdanshenas; Nicholas M Bernthal; Arya N Shamie Journal: Spine J Date: 2016-11-14 Impact factor: 4.166