Francesco Muratori1, Lorenzo Foschi2, Giuliana Roselli3, Filippo Frenos2, Angela Tamburini4, Annarita Palomba5, Daniela Greto6, Mauro Loi6, Giovanni Beltrami7, Rodolfo Capanna8, Nicola Mondanelli9, Domenico Andrea Campanacci2. 1. Department of Orthopaedic Oncology, Azienda Ospedaliera Universitaria Careggi, Largo Palagi 1, Firenze, Italy. fmuratori@inwind.it. 2. Department of Orthopaedic Oncology, Azienda Ospedaliera Universitaria Careggi, Largo Palagi 1, Firenze, Italy. 3. Department of Radiology, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy. 4. Department of Paediatric Oncoematology, Azienda Ospedaliera Universitaria Meyer, Firenze, Italy. 5. Department of Pathology, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy. 6. Department of Radiotherapy, Azienda Ospedaliera Universitaria Careggi, Firenze, Italy. 7. Department of Paediatric Orthopaedics, Azienda Ospedaliera Universitaria Meyer, Firenze, Italy. 8. Orthopaedic Clinic, Azienda Ospedaliera Universitaria Pisana, Pisa, Italy. 9. Orthopaedic Clinic, Azienda Ospedaliera Universitaria Senese, Siena, Italy.
Abstract
PURPOSE: Authors retrospectively analyzed possible prognostic factors in a series of patients affected by Ewing sarcoma of extremities (eEWS) and treated over a 20-year period at a single institution. METHODS: Between 1997 and 2017, 88 bone eEWS were treated at our institution. Staging, age, gender, tumoral volume, local treatment, surgical margins, post-ChT necrosis were investigated for prognostic correlation with overall survival (OS) and event-free survival (EFS). Median follow-up was 74 months (1-236). RESULTS: Staging of disease correlated with OS (81% vs 59%, p = 0.01) and not with EFS (68% vs 57%, p = 0.28) in localized vs metastatic eEWS at presentation. Age ≥ 14 years (p = 0.002) and volume ≥ 100 cm3 (p = 0.04) were significant negative prognostic factors. No difference was found in local treatment: OS was 76% vs 63% (p = 0.33), while EFS was 68% vs 49% (p = 0.06) after surgery alone or surgery + radiotherapy, respectively. Regarding surgical margins, OS was 76% vs 38% (p = 0.14), and EFS was 65% vs 33% (p = 0.14) in adequate vs not adequate, respectively. OS was 86% and 68% in good and poor responders, respectively (p = 0.13). CONCLUSION: In eEWS, metastatic disease at presentation, age > 14 years and tumoral volume > 100 cm3 are negative prognostic factors. Intensified adjuvant ChT can improve prognosis in poor responders and metastatic patients.
PURPOSE: Authors retrospectively analyzed possible prognostic factors in a series of patients affected by Ewing sarcoma of extremities (eEWS) and treated over a 20-year period at a single institution. METHODS: Between 1997 and 2017, 88 bone eEWS were treated at our institution. Staging, age, gender, tumoral volume, local treatment, surgical margins, post-ChT necrosis were investigated for prognostic correlation with overall survival (OS) and event-free survival (EFS). Median follow-up was 74 months (1-236). RESULTS: Staging of disease correlated with OS (81% vs 59%, p = 0.01) and not with EFS (68% vs 57%, p = 0.28) in localized vs metastatic eEWS at presentation. Age ≥ 14 years (p = 0.002) and volume ≥ 100 cm3 (p = 0.04) were significant negative prognostic factors. No difference was found in local treatment: OS was 76% vs 63% (p = 0.33), while EFS was 68% vs 49% (p = 0.06) after surgery alone or surgery + radiotherapy, respectively. Regarding surgical margins, OS was 76% vs 38% (p = 0.14), and EFS was 65% vs 33% (p = 0.14) in adequate vs not adequate, respectively. OS was 86% and 68% in good and poor responders, respectively (p = 0.13). CONCLUSION: In eEWS, metastatic disease at presentation, age > 14 years and tumoral volume > 100 cm3 are negative prognostic factors. Intensified adjuvant ChT can improve prognosis in poor responders and metastatic patients.
Authors: Jianjun Zhang; Yujing Huang; Jing Lu; Aina He; Yan Zhou; Haiyan Hu; Zan Shen; Yuanjue Sun; Yang Yao Journal: Am J Cancer Res Date: 2018-07-01 Impact factor: 6.166