Age dependency of primary tumor sites and metastases in patients with Ewing sarcoma

Worch, Jennifer; Ranft, Andreas; DuBois, Steven G.; Paulussen, Michael; Juergens, Heribert; Dirksen, Uta

doi:10.1002/pbc.27251

Cited by 33 publications

(33 citation statements)

References 25 publications

(47 reference statements)

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“…Applebaum et al 18 indicated that regional node involvement may be an independent adverse prognostic factor in EWS and should be investigated carefully when diagnosed with EES. In contrast, Worch et al 19 demonstrated that in patients with SES the tumors were more frequently transferred to the lung, followed by bone and bone marrow. Those findings suggested that the metastatic pattern may be different between EES and SES, although there was no difference in metastatic status in our study.…”

Section: Discussionmentioning

confidence: 91%

Comparison of clinical features and outcomes in patients with extraskeletal vs skeletal Ewing sarcoma: an SEER database analysis of 3,178 cases

Jiang¹,

Wang²,

Chen³

et al. 2018

CMAR

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BackgroundThe clinicopathological characteristics, outcomes and prognostic factors of primary extraskeletal Ewing sarcoma (EES) remained insufficiently explored. We aimed to examine these aspects and compared the same with skeletal Ewing sarcoma (SES).Patients and methodsWe identified Ewing sarcoma, peripheral primitive neuroectodermal tumors or Askin tumor patients who were registered in the Surveillance, Epidemiology, and End Results database from 1973 to 2014. Clinicopathological features were assessed by using Fisher’s exact tests. Cancer-specific survival (CSS) and overall survival (OS) were estimated by using the Kaplan–Meier method and the Cox proportional hazards model. Prognostic factors were identified by multivariate Cox regression analysis.ResultsThe age of patients with EES was diagnosed to be higher and they were more likely to be female (46.1% vs 36.2%; P<0.001), have tumor <10 cm (49.8% vs 35.4%; P<0.001), have regional node involvement (5.4% vs 1.0%; P<0.001) and receive surgery (69.1% vs 53.8%; P<0.001) compared to patients with skeletal tumors. Metastatic status did not differ by origin. Kaplan–Meier analysis showed that the origin had significant difference in CSS and OS among patients aged 0–19 years and with metastatic stage at presentation, but not in patients aged 20–39, ≥40 years and with no-metastatic stage. A Cox multivariable model controlling for differences between groups confirmed inferior survival for patients with EES. Age, tumor size, tumor stage and surgery were the most important factors significantly influencing both CSS and OS in the EES and SES patients. Race, year of diagnosis and tumor site were associated with CSS and OS among patients with SES, but failed in EES.ConclusionThe clinicopathological characteristics, outcomes and prognostic factors differed among patients with EES compared to patients with SES. Extraskeletal origin was an unfavorable prognostic factor.

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Section: Discussionmentioning

confidence: 91%

Comparison of clinical features and outcomes in patients with extraskeletal vs skeletal Ewing sarcoma: an SEER database analysis of 3,178 cases

Jiang¹,

Wang²,

Chen³

et al. 2018

CMAR

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“…Five of these studies reported the incidence of BMM in a selected population of ES patients (Table 2). 2,32–35 Of these, three excluded patients with newly diagnosed localized ES and reported on 934 total patients with newly diagnosed metastatic ES. Of these, 19.0% were reported to have BMM.…”

Section: Resultsmentioning

confidence: 99%

“…2,[32][33][34][35] Of these, three excluded patients with newly diagnosed localized ES and reported on 934 total patients with newly diagnosed metastatic ES. Of these, 19.0% were reported to have BMM.Two other studies described further subsets of metastatic ES patients.One excluded patients with lung only metastatic disease and reported an incidence of BMM of 43.8%(123/281) 2.…”

mentioning

confidence: 99%

Role of bone marrow biopsy for staging new patients with Ewing sarcoma: A systematic review

Campbell

Shulman

Grier

et al. 2020

Pediatric Blood & Cancer

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The incidence of bone marrow metastasis (BMM) in newly diagnosed Ewing sarcoma (ES) is variable across studies. An optimal staging strategy for detecting BMM is not defined. While bone marrow (BM) biopsy and/or aspirate (BMBA) have been the gold standard, [F-18]fluorodeoxyglucose positron emission tomography (FDG-PET) to detect BMM may decrease reliance on BMBA. We conducted a systematic review to assess incidence of BMM and the role of FDG-PET. We observed a pooled incidence of BMM by BMBA of 4.8% in all newly diagnosed ES patients and 17.5% among patients with metastatic disease. Only 1.2% of patients had BMM as their sole metastatic site. FDG-PET detection of BMM compared to BMBA demonstrated pooled 100% sensitivity and 96% specificity, positive predictive value of 75%, and negative predictive value of 100%. In the era of FDG-PET imaging, omission of BMBA may be considered in patients with otherwise localized disease after initial staging studies.

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“…The most common metastatic sites are the lungs (~90% of all cases), other bones, and lymph nodes [165,166]. In the case of chondrosarcoma, skeletal and lung metastases are detected at diagnosis or within 12-18 months in the case of dedifferentiated chondrosarcoma (10% of cases), whereas Ewing sarcoma has a high propensity to metastasize to the lungs, bone and bone marrow [167][168][169].…”

Section: Bone Cancermentioning

confidence: 99%

Role of VEGFs/VEGFR-1 Signaling and Its Inhibition in Modulating Tumor Invasion: Experimental Evidence in Different Metastatic Cancer Models

Ceci

Atzori

Lacal

et al. 2020

IJMS

147

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The vascular endothelial growth factor (VEGF) family members, VEGF-A, placenta growth factor (PlGF), and to a lesser extent VEGF-B, play an essential role in tumor-associated angiogenesis, tissue infiltration, and metastasis formation. Although VEGF-A can activate both VEGFR-1 and VEGFR-2 membrane receptors, PlGF and VEGF-B exclusively interact with VEGFR-1. Differently from VEGFR-2, which is involved both in physiological and pathological angiogenesis, in the adult VEGFR-1 is required only for pathological angiogenesis. Besides this role in tumor endothelium, ligand-mediated stimulation of VEGFR-1 expressed in tumor cells may directly induce cell chemotaxis and extracellular matrix invasion. Furthermore, VEGFR-1 activation in myeloid progenitors and tumor-associated macrophages favors cancer immune escape through the release of immunosuppressive cytokines. These properties have prompted a number of preclinical and clinical studies to analyze VEGFR-1 involvement in the metastatic process. The aim of the present review is to highlight the contribution of VEGFs/VEGFR-1 signaling in the progression of different tumor types and to provide an overview of the therapeutic approaches targeting VEGFR-1 currently under investigation.

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Age dependency of primary tumor sites and metastases in patients with Ewing sarcoma

Abstract: Site of primary and metastatic tumor involvement in EwS differs according to patient age. The biological and developmental etiology for these differences requires further investigations.

Cited by 33 publications

References 25 publications

Comparison of clinical features and outcomes in patients with extraskeletal vs skeletal Ewing sarcoma: an SEER database analysis of 3,178 cases

Comparison of clinical features and outcomes in patients with extraskeletal vs skeletal Ewing sarcoma: an SEER database analysis of 3,178 cases

Role of bone marrow biopsy for staging new patients with Ewing sarcoma: A systematic review

Role of VEGFs/VEGFR-1 Signaling and Its Inhibition in Modulating Tumor Invasion: Experimental Evidence in Different Metastatic Cancer Models

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