Clinical features and outcomes of infants with Ewing sarcoma under 12 months of age

Wong, Teck Huat; Goldsby, Robert E.; Wustrack, Rosanna; Cash, Thomas F.; Isakoff, Michael S.; DuBois, Steven G.

doi:10.1002/pbc.25635

Cited by 19 publications

(18 citation statements)

References 31 publications

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“…Large national databases and international collaborations are essential tools for studying epidemiology, outcomes, and trends in order to develop treatment guidelines and guide future research. Oncology registries such as SEER provide excellent data on long-term prognosis and survival trends but fail to capture short-term treatment specific morbidity [13][14][15][16][17][18][19][20]. NSQIP-P is a large, national registry capturing patient demographics, comorbidities, and perioperative complications, making it an ideal tool to study patient characteristics and short-term outcomes after surgical management of sarcomas.…”

Section: Discussionmentioning

confidence: 99%

“…ese data are essential for determining the efficacy of treatment protocols and the incidence of long-term sequelae. However, a frequently cited limitation of SEER and other long-range studies is the lack of data on patient comorbidities and postoperative complications [13][14][15][16][17][18][19][20]. Understanding of treatment specific morbidity is an essential component of preoperative planning.…”

Section: Introductionmentioning

confidence: 99%

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Thirty-Day Outcomes following Pediatric Bone and Soft Tissue Sarcoma Surgery: A NSQIP Pediatrics Analysis

Gallaway

Ahn

Callan

2020

Sarcoma

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Background. Pediatric bone and soft tissue sarcomas are rare; therefore, national registries are essential tools for orthopedic oncology research. Past studies provide excellent data on long-term prognosis and survival trends but fail to examine treatment-specific morbidity. The aim of this study is to use a national registry to describe patient demographics, comorbidities, and adverse events in the first thirty days following surgical management of pediatric bone and soft tissue sarcomas. Methods. A retrospective review of patients in the American College of Surgeons National Surgical Quality Improvement Program—Pediatrics database (NSQIP-P) was performed. The cohort was partitioned by tumor origin (bone versus soft tissue) and tumor location (axial versus appendicular). Results. One-hundred ninety-two patients were identified. Bone sarcomas were more common (71.9%) and predominately appendicular (62.3%), while soft tissue sarcomas were predominately axial (77.8%). The overall complication rate was 8.9%. The most frequent etiologies were wound dehiscence (3.6%) and infectious complications such as surgical site infections (2.6%), pneumonia (1.6%), urinary tract infections (1.6%), and C. diff colitis (1.0%). Twenty-four percent of patients experienced bleeding requiring transfusion. The unplanned readmission rate was 12.5% (3.6% related to principle procedure), and the unplanned reoperation rate was 4.7% (4.2% related to principle procedure). The mortality rate was 1.0%. Neoadjuvant chemotherapy was associated with higher rates of wound dehiscence and infectious complications. There were no differences in adverse events with respect to tumor origin or location. Conclusion. Approximately 1 in 11 pediatric patients will experience a complication in the first thirty days following surgery. However, perioperative mortality remains low. This study represents the first comprehensive review of pediatric bone and soft tissue sarcoma surgery in the NSQIP-P database. As the case volume of NSQIP-P continues to grow, NSQIP-P has the potential to become a powerful tool for pediatric orthopedic oncology research.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Thirty-Day Outcomes following Pediatric Bone and Soft Tissue Sarcoma Surgery: A NSQIP Pediatrics Analysis

Gallaway

Ahn

Callan

2020

Sarcoma

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“…The role of various treatment paradigms in these subgroups is uncertain. Similarly, the infant (<12 months) subgroup has been studied as another example, determining a potential increase in early death but similar OS (14). In addition, studying a large-volume cohort of ESFTs treated in the present decade using the most modern surgical techniques, chemotherapy regimens, and radiotherapy technologies [including proton beam therapy (15, 16)] is of great necessity to determine that the results presented herein are accurate and representative of modern treatment paradigms.…”

Section: Discussionmentioning

confidence: 99%

A Comparison of Pediatric vs. Adult Patients with the Ewing Sarcoma Family of Tumors

et al. 2017

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PurposeThis study sought to identify differences in clinical characteristics, outcomes, and treatments between adult and pediatric patients with the Ewing sarcoma family of tumors (ESFT).MethodsBy using the Surveillance, Epidemiology, and End Results database from 1983 to 2013, 1,870 patients were analyzed (n = 976 pediatric, n = 894 adult). Between the two groups, demographic, tumor, and treatment characteristics were collated and compared. The chi-square test determined differences in proportions of the variables between groups. Survival analysis was performed using the Kaplan–Meier method; distributions were compared using the log-rank test. Univariate and multivariate analyses were performed to examine variables correlating with overall survival (OS), the primary endpoint.ResultsAdult patients had a poorer prognosis and were more likely to present with primitive neuroectodermal tumor (PNET) histology, along with distant metastasis and soft tissue primary site. In patients undergoing surgery, radiation therapy (RT) was not associated with higher OS in either children or adults. If no surgery was performed, receipt of RT was associated with higher OS in adults but not children. Adulthood negatively correlated with OS on multivariate analysis when adjusting for potential confounding factors. Other salient factors associated with OS were male gender, metastatic disease, non-extremity bone location, treatment era, and PNET histology. However, when examining the most recent subset (patients treated from 2004 to 2013), RT was associated with improved OS in both pediatrics and adults, which was an independent predictor on multivariate analysis.ConclusionAdult patients with ESFT have inferior survival compared to pediatric patients, likely related to earlier clinical detection in the latter.

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“…There are also rare documented cases of Ewing Sarcoma in infants and young children. [63][64][65] Unlike OS, 85-95% of ESFT tumors carry specific genetic aberrations to be discussed below.…”

Section: Incidence and Epidemiologymentioning

confidence: 99%

Pediatric Malignant Bone Tumors: A Review and Update on Current Challenges, and Emerging Drug Targets

Jackson

Bittman

Granowetter

2016

Current Problems in Pediatric and Adolescent Health Care

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Clinical features and outcomes of infants with Ewing sarcoma under 12 months of age

Abstract: Ewing sarcoma is rare in infants, with different clinical presentations and treatment approaches. These patients appear to be at higher risk for early death, but long-term survival is similar to older pediatric patients.

Cited by 19 publications

References 31 publications

Thirty-Day Outcomes following Pediatric Bone and Soft Tissue Sarcoma Surgery: A NSQIP Pediatrics Analysis

Thirty-Day Outcomes following Pediatric Bone and Soft Tissue Sarcoma Surgery: A NSQIP Pediatrics Analysis

A Comparison of Pediatric vs. Adult Patients with the Ewing Sarcoma Family of Tumors

Pediatric Malignant Bone Tumors: A Review and Update on Current Challenges, and Emerging Drug Targets

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