Gehad Ahmed1, Manal Zamzam2, Mohamed S Zaghloul3, Ahmed Kamel2, Ranin Soliman4, Iman Zaky5, Asmaa Salama6, Nehal Kamal7, Maged ElShafiey8. 1. Surgical Oncology Department, Children's Cancer Hospital (CCHE), 57357, Egypt; Faculty of Medicine, Helwan University, Egypt. Electronic address: Gehad.taha@gmail.com. 2. Pediatric Oncology Department, CCHE, Egypt; National Cancer Institute, Cairo University, Egypt. 3. Radiation Therapy Department, CCHE, Egypt; National Cancer Institute, Cairo University, Egypt. 4. Healthcare Outcomes and Economics, CCHE, Egypt. 5. Radiodiagnosis Department, CCHE, Egypt; National Cancer Institute, Cairo University, Egypt. 6. Pathology Department, CCHE, Egypt; National Cancer Institute, Cairo University, Egypt. 7. Research Department, CCHE, Egypt. 8. Surgical Oncology Department, Children's Cancer Hospital (CCHE), 57357, Egypt; National Cancer Institute, Cairo University, Egypt.
Abstract
PURPOSE: Was to evaluate the outcome of multimodality treatment in resectable primary Ewing sarcoma/primitive neuroectodermal tumor ES/PNET of the ribs and role of thoracoscopy in facilitating resection of these tumors. PATIENTS AND METHODS: This was a retrospective study including 22 patients with primary ES/PNET of the ribs surgically treated at Children's Cancer Hospital Egypt (CCHE) between January 2008 until the end of December 2014. RESULTS: Median age was 8.5years (range 5months to 16years.). All patients received neoadjuvant chemotherapy. Thoracoscopic exploration was performed in 15 (68%) patients. Resection included 1,2,3 and 4 ribs in (7,4,8 and 3 patients) respectively, parts of the diaphragm (3 patients), wedge resection of the lung (10 patients) and pleural nodules (2 patients). Primary closure was feasible in 11 patients and rib transposition was done in one patient. Reconstruction by proline mesh covered by muscle flap was done in 10 patients. Margins were microscopically positive in 3 patients and close in 2 patients. Postoperative radiotherapy was given in 8 patients. With a median follow-up of 38.5months, the 3-year event -free survival (EFS) and overall survival(OS) rates were 31.6% and 55.6%, respectively. CONCLUSION: Multimodality treatment is essential in the management of ES-PNET of the ribs. Neoadjuvant chemotherapy facilitates adequate resection. The role of thoracoscopy and the indications of postoperative radiotherapy need further evaluation.
PURPOSE: Was to evaluate the outcome of multimodality treatment in resectable primary Ewing sarcoma/primitive neuroectodermal tumor ES/PNET of the ribs and role of thoracoscopy in facilitating resection of these tumors. PATIENTS AND METHODS: This was a retrospective study including 22 patients with primary ES/PNET of the ribs surgically treated at Children's Cancer Hospital Egypt (CCHE) between January 2008 until the end of December 2014. RESULTS: Median age was 8.5years (range 5months to 16years.). All patients received neoadjuvant chemotherapy. Thoracoscopic exploration was performed in 15 (68%) patients. Resection included 1,2,3 and 4 ribs in (7,4,8 and 3 patients) respectively, parts of the diaphragm (3 patients), wedge resection of the lung (10 patients) and pleural nodules (2 patients). Primary closure was feasible in 11 patients and rib transposition was done in one patient. Reconstruction by proline mesh covered by muscle flap was done in 10 patients. Margins were microscopically positive in 3 patients and close in 2 patients. Postoperative radiotherapy was given in 8 patients. With a median follow-up of 38.5months, the 3-year event -free survival (EFS) and overall survival(OS) rates were 31.6% and 55.6%, respectively. CONCLUSION: Multimodality treatment is essential in the management of ES-PNET of the ribs. Neoadjuvant chemotherapy facilitates adequate resection. The role of thoracoscopy and the indications of postoperative radiotherapy need further evaluation.
Authors: Ahmed Mohammed Morsy; Salah Abdel-Hadi; Khalid Mohammed Rezk; Gamal Amira; Badawy Mohammed Ahmed; Marwa Tammam Hussien; Mahmoud Gamal Ameen; Hosam Eldein Mostafa Kamel; Doaa Mohamed Fouad; Alia Mohamed Attia; Asmaa Salah; Osama Mostafa Abd Elbadee; Ayatallah Ali Yousseif; Marwa Ismail Abdelgawad; Asmaa Hussein Fathy; Yasmine Nagy Elwany; Islam Karam-Allah Ramadan; Khaled Hassan Mosallam; Ahmed Ibrahim Abd Elwahab; Khaled Hashim Mahmoud; Maged Abdel Fattah Amine; Ahmed Refaat Abd Elzaher; Hanan Ahmed Eltyb; Ahmed Mubarak Hefni Journal: Am J Cancer Res Date: 2021-06-15 Impact factor: 6.166