Archana Sasi1, Shuvadeep Ganguly1, Bivas Biswas2, Deepam Pushpam1, Akash Kumar3, Sandeep Agarwala4, Shah Alam Khan5, Venkatesan Sampath Kumar5, Suryanarayana Deo6, Daya Nand Sharma7, Ahitagni Biswas7, Asit Mridha8, Adarsh Barwad8, Sanjay Thulkar9, Sameer Bakhshi1. 1. Department of Medical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences New Delhi, India. 2. Department of Medical Oncology, Tata Medical Centre Kolkata, India. 3. Department of Medical Oncology, National Cancer Institute Jhajjar, Haryana, India. 4. Department of Paediatric Surgery, All India Institute of Medical Sciences New Delhi, India. 5. Department of Orthopaedics, All India Institute of Medical Sciences New Delhi, India. 6. Department of Surgical Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences New Delhi, India. 7. Department of Radiation Oncology, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences New Delhi, India. 8. Department of Pathology, All India Institute of Medical Sciences New Delhi, India. 9. Department of Radiodiagnosis, Dr. B.R.A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences New Delhi, India.
Abstract
INTRODUCTION: Prognostic scores in Ewing sarcoma including baseline clinical and laboratory characteristics are necessary for pre-treatment risk stratification. In this study, we formulated and validated a prognostic model for baseline risk categorization in Ewing sarcoma. MATERIALS AND METHODS: A retrospective single-institutional study was conducted on Ewing sarcoma patients treated uniformly between January 2003 and December 2018. Baseline clinical/pathological characteristics and survival outcomes were noted from medical records. The cohort was randomised into a derivation and validation cohort. A prognostic score was formulated by including independent prognostic factors from the derivation cohort by multivariable analysis. The prognostic model was validated in the validation cohort along with estimation of its predictive ability. RESULTS: A total of 860 patients were included with 40.3% having baseline metastases. Tumor diameter >5 cm (HR 2.04; P<0.001; score 2), baseline metastases (HR 2.33; P<0.001, score 2), and total leucocyte count >11000/mm3 (HR 1.44; P=0.015; score 1) were independent predictors of overall survival in derivation cohort and included for prognostic score calculation. Patients were categorized into low (score 0), intermediate (score 1-3) and high-risk (score 4-5) groups. Harrell's c-indexes of the model were 0.625, 0.622 and 0.624 in the derivation, validation and whole cohort respectively. The timed AUC of ROC of the prognostic score-group for 5-year survival was 0.72, 0.71 and 0.73 in the derivation, validation and whole cohort respectively. CONCLUSIONS: We have formulated and validated a prognostic score for Ewing sarcoma incorporating baseline clinical and laboratory parameters, with fair predictive ability for risk stratification and facilitating risk-adapted personalized therapy. AJTR
INTRODUCTION: Prognostic scores in Ewing sarcoma including baseline clinical and laboratory characteristics are necessary for pre-treatment risk stratification. In this study, we formulated and validated a prognostic model for baseline risk categorization in Ewing sarcoma. MATERIALS AND METHODS: A retrospective single-institutional study was conducted on Ewing sarcoma patients treated uniformly between January 2003 and December 2018. Baseline clinical/pathological characteristics and survival outcomes were noted from medical records. The cohort was randomised into a derivation and validation cohort. A prognostic score was formulated by including independent prognostic factors from the derivation cohort by multivariable analysis. The prognostic model was validated in the validation cohort along with estimation of its predictive ability. RESULTS: A total of 860 patients were included with 40.3% having baseline metastases. Tumor diameter >5 cm (HR 2.04; P<0.001; score 2), baseline metastases (HR 2.33; P<0.001, score 2), and total leucocyte count >11000/mm3 (HR 1.44; P=0.015; score 1) were independent predictors of overall survival in derivation cohort and included for prognostic score calculation. Patients were categorized into low (score 0), intermediate (score 1-3) and high-risk (score 4-5) groups. Harrell's c-indexes of the model were 0.625, 0.622 and 0.624 in the derivation, validation and whole cohort respectively. The timed AUC of ROC of the prognostic score-group for 5-year survival was 0.72, 0.71 and 0.73 in the derivation, validation and whole cohort respectively. CONCLUSIONS: We have formulated and validated a prognostic score for Ewing sarcoma incorporating baseline clinical and laboratory parameters, with fair predictive ability for risk stratification and facilitating risk-adapted personalized therapy. AJTR
Authors: Jennifer Worch; Andreas Ranft; Steven G DuBois; Michael Paulussen; Heribert Juergens; Uta Dirksen Journal: Pediatr Blood Cancer Date: 2018-06-01 Impact factor: 3.167
Authors: Stefan K Zöllner; James F Amatruda; Sebastian Bauer; Stéphane Collaud; Enrique de Álava; Steven G DuBois; Jendrik Hardes; Wolfgang Hartmann; Heinrich Kovar; Markus Metzler; David S Shulman; Arne Streitbürger; Beate Timmermann; Jeffrey A Toretsky; Yasmin Uhlenbruch; Volker Vieth; Thomas G P Grünewald; Uta Dirksen Journal: J Clin Med Date: 2021-04-14 Impact factor: 4.241
Authors: S E Bosma; C Lancia; A J Rueten-Budde; A Ranft; H Gelderblom; M Fiocco; M A J van de Sande; P D S Dijkstra; U Dirksen Journal: Sci Rep Date: 2019-07-29 Impact factor: 4.379
Authors: Neyssa Marina; Linda Granowetter; Holcombe E Grier; Richard B Womer; R Lor Randall; Karen J Marcus; Elizabeth McIlvaine; Mark Krailo Journal: Sarcoma Date: 2015-10-05