Local therapy in localized Ewing tumors: results of 1058 patients treated in the CESS 81, CESS 86, and EICESS 92 trials

Schuck, Andreas; Ahrens, S.; Paulussen, Michael; Kuhlen, Michaela; Könemann, Stefan; Rübe, Christian; Winkelmann, Winfried; Kotz, R.; Dunst, Jürgen; Willich, Normann; Jürgens, Heribert

doi:10.1016/s0360-3016(02)03797-5

Cited by 310 publications

(286 citation statements)

References 21 publications

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“…The development of limb salvage surgery [2, 13, 32] was a major advance in treatment of primary bone sarcomas [14,16,31], allowing patients potentially to return to sport in ways not possible when amputations were the mainstay of treatment. Currently, limb salvage procedures are still the first choice in primary bone sarcoma surgery, although developmental changes in technical orthopaedics have led to high levels of sports activity in amputees [7,9].…”

Section: Discussionmentioning

confidence: 99%

“…Ewing's sarcoma differs from osteosarcoma in some respects: the mean age of the patients is younger than those with osteosarcoma and seldom occurs beyond the age of 30 years, local control can be achieved with radiation as well as resection, and the drugs used to treat Ewing's sarcoma are different than those used to treat osteosarcoma [3,20,31]. In addition to adequate local control, the use of aggressive polychemotherapy has remarkably improved the survival of patients with Ewing's sarcoma [10,25,32,37] since adjuvant chemotherapy was first introduced in the 1980s and has led to a growing number of long-term survivors [8,20,23].…”

Section: Introductionmentioning

confidence: 99%

“…Although the functional status of patients with Ewing's sarcoma after limb salvage treatment has been assessed using basic musculoskeletal scores like the Musculoskeletal Tumor Society (MSTS) score in previous studies [14,16,24,26,31,37] and limitations in sports have been recently described [27], no detailed data are available on the sports activity levels of longer-term survivors.…”

Section: Introductionmentioning

confidence: 99%

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Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Hobusch

Lang

Schuh

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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Background Limb salvage surgery has evolved to become the standard method of treating sarcomas of the extremities with acceptable oncologic results. However, little information exists relative to the activity level or ability to participate in sports after tumor reconstructions. Questions/purposes The aims of the study were to answer the following questions: (1) Which sports activity levels and what types of sports can be expected in the long term after tumor reconstruction? (2) Which frequency durations are patients with Ewing's sarcoma able to perform in longterm followup after local control? (3) Do surgical complications affect sports activity level? Methods Thirty patients (13 females, 17 males; mean age, 18 ± 8 years; range, 2-36 years at diagnosis; mean followup 16 ± 6 years [minimum, 5 years]) were included. Tumors were located in the pelvis, femur, tibia, and fibula. Surgical procedures included surgical resections alone (n = 8), surgical resection with biological reconstruction (n = 9), or endoprosthetic reconstruction (n = 13). We assessed UCLA sports activity levels, kinds of sports as well as the frequency per week and the duration of each training unit at long term (minimum followup, 5 years). Results In long-term followup 83% patients (25 of 30) were performing athletic activity regularly. The hours/ week of sports depended on type of surgery and were highest after resections in the pelvis and femur (5.8) and were lowest after megaprosthetic reconstruction of the pelvis (1.0). Patients undergoing biologic reconstructions were able to perform high-impact sports. UCLA sports activity levels were high after joint-preserving vascularized fibula for tibia reconstruction (7.4) and after megaprosthetic reconstruction of the lower extremity (6.3-6.4) and were low after tumors located in the fibula (4.2). Complications during followup did not significantly influence sports activity in long-term survivors.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Hobusch

Lang

Schuh

et al. 2015

Clinical Orthopaedics &Amp; Related Research

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“…Although some studies demonstrated no significant differences in the rates of local recurrence and/or survival between patients who received radiotherapy alone and patients who underwent surgery, 9,26,33 other studies demonstrated that surgery improved clinical outcomes significantly. 34,35 Results from 1058 patients who were treated on Cooperative Ewing Sarcoma Study 81 (CESS 81), CESS 86, and European Intergroup Cooperative Ewing Sarcoma Study 92 demonstrated that local control and EFS among patients who received definitive radiotherapy was significantly lower than EFS among patients who underwent surgery with or without receiving additional radiotherapy, although the former subgroup of patients represented a negatively selected population with unfavorable tumor sites. 35 Similar results were obtained in the current study.…”

Section: Discussionmentioning

confidence: 99%

“…34,35 Results from 1058 patients who were treated on Cooperative Ewing Sarcoma Study 81 (CESS 81), CESS 86, and European Intergroup Cooperative Ewing Sarcoma Study 92 demonstrated that local control and EFS among patients who received definitive radiotherapy was significantly lower than EFS among patients who underwent surgery with or without receiving additional radiotherapy, although the former subgroup of patients represented a negatively selected population with unfavorable tumor sites. 35 Similar results were obtained in the current study. To eliminate such a selection bias, Bacci et al retrospectively evaluated patients with tumors located exclusively in the extremities.…”

Section: Discussionmentioning

confidence: 99%

Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

Obata

Ueda

Kawai

et al. 2007

Cancer

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BACKGROUND.Ewing sarcoma family of tumors (ESFT) of bone is extremely rare in Japan. The objectives of the current study were to assess the clinical outcome and prognostic factors of patients with ESFT of bone in Japan and to compare them between Euro‐American and Japanese populations.METHODS.The authors conducted a retrospective analysis of 243 patients who were treated for ESFT of bone in Japan between 1981 and 2003. Local therapy was surgery in 35% of patients, surgery combined with radiotherapy in 40% of patients, radiotherapy alone in 22% of patients, and no local treatment in 3% of patients. All but 3 patients received various regimens of multidrug chemotherapy.RESULTS.The median patient age was 16 years. The primary disease sites were the trunk in 53% of patients and the extremities in 47% of patients. Forty‐one patients had metastases at presentation. The median follow‐up was 66 months. A univariate survival analysis demonstrated that patients who had metastases at presentation, primary site in the trunk, age ≥16 years, tumor size ≥10 cm, tumor that responded poorly to induction chemotherapy, and local treatment with radiotherapy alone had a significantly worse event‐free survival (EFS). A multivariate analysis further verified that the former 3 factors were significant adverse prognostic factors. Of 201 patients with localized disease, 45 patients who received current chemotherapy regimens that included ifosfamide and etoposide had a significantly better 5‐year EFS rate (67.6%) compared with other patients.CONCLUSIONS.The clinical outcome of patients with localized ESFT of bone in Japan has improved markedly with the use of current chemotherapy regimens that include ifosfamide and etoposide and has become comparable to the outcomes observed in other major series of Euro‐American patients. The prognostic factors are also almost identical. Cancer 2007 © 2007 American Cancer Society.

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Radiotherapy for localised Ewing’s sarcoma in children

Qadir¹,

Abbasi²,

Das³

et al. 2014

Cochrane Database of Systematic Reviews

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Local therapy in localized Ewing tumors: results of 1058 patients treated in the CESS 81, CESS 86, and EICESS 92 trials

Cited by 310 publications

References 21 publications

Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Do Patients With Ewing's Sarcoma Continue With Sports Activities After Limb Salvage Surgery of the Lower Extremity?

Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

Radiotherapy for localised Ewing’s sarcoma in children

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