Long-Term Follow-Up and Prognostic Factors in Ewing’s Sarcoma

Aparicio, Jorge; Munárriz, Blanca; Pastor, M.; Vera, Francisco Javier García; Castel, Victoria; Aparisi, Francisco; Montalar, Joaquín; Badal,; Gómez-Codina, José; Herranz, Constantino

doi:10.1159/000011841

Cited by 45 publications

(9 citation statements)

References 22 publications

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“…It was concluded that presurgical serum albumin levels can be used to evaluate the success of randomization of clinical trials for glioblastoma multiforme therapies [91]. Another showed that raised serum LDH levels, hypoalbuminemia and distant metastases at diagnosis were independent adverse prognostic factors in 116 patients with Ewing's sarcoma [92]. A study done with an objective of determining prognostic factors for survival in renal cancer patients found the following variables to be statistically significant at the univariate analysis (p < 0.01): disease free interval (DFI), PS, stage at diagnosis, grading, nephrectomy, sites of metastases, blood hemoglobin, serum albumin, calcium, LDH, ALP [93].…”

Section: Resultsmentioning

confidence: 99%

Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literature

Gupta

Lis

2010

Nutr J

1,099

870

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BackgroundThere are several methods of assessing nutritional status in cancer of which serum albumin is one of the most commonly used. In recent years, the role of malnutrition as a predictor of survival in cancer has received considerable attention. As a result, it is reasonable to investigate whether serum albumin has utility as a prognostic indicator of cancer survival in cancer. This review summarizes all available epidemiological literature on the association between pretreatment serum albumin levels and survival in different types of cancer.MethodsA systematic search of the literature using the MEDLINE database (January 1995 through June 2010) to identify epidemiologic studies on the relationship between serum albumin and cancer survival. To be included in the review, a study must have: been published in English, reported on data collected in humans with any type of cancer, had serum albumin as one of the or only predicting factor, had survival as one of the outcome measures (primary or secondary) and had any of the following study designs (case-control, cohort, cross-sectional, case-series prospective, retrospective, nested case-control, ecologic, clinical trial, meta-analysis).ResultsOf the 29 studies reviewed on cancers of the gastrointestinal tract, all except three found higher serum albumin levels to be associated with better survival in multivariate analysis. Of the 10 studies reviewed on lung cancer, all excepting one found higher serum albumin levels to be associated with better survival. In 6 studies reviewed on female cancers and multiple cancers each, lower levels of serum albumin were associated with poor survival. Finally, in all 8 studies reviewed on patients with other cancer sites, lower levels of serum albumin were associated with poor survival.ConclusionsPretreatment serum albumin levels provide useful prognostic significance in cancer. Accordingly, serum albumin level could be used in clinical trials to better define the baseline risk in cancer patients. A critical gap for demonstrating causality, however, is the absence of clinical trials demonstrating that raising albumin levels by means of intravenous infusion or by hyperalimentation decreases the excess risk of mortality in cancer.

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Section: Resultsmentioning

confidence: 99%

Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literature

Gupta

Lis

2010

Nutr J

1,099

870

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“…In bone sarcomas, CRP, albumin level [24], [25], and lymphocyte and/or neutrophils [26], [27] were shown to be of prognostic value. These few studies, however, suffer from different problems such as not correcting for confounders and the lack of pretreatment values or hazard ratio levels.…”

Section: Discussionmentioning

confidence: 99%

The Prognostic Value of Serum Biomarkers in Localized Bone Sarcoma

Aggerholm‐Pedersen

Maretty-Kongstad

Keller

et al. 2016

Translational Oncology

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OBJECTIVE: Certain biomarkers such as the C-reactive protein, serum albumin, and the neutrophils to lymphocyte ratio are of prognostic significance regarding survival in different types of cancers. Data from sarcoma patients are sparse and mainly derived from soft tissue sarcoma and/or metastatic cases. Adjusting for confounders such as comorbidity and age is an essential safeguard against erroneous conclusions regarding the possible prognostic value of these biomarkers. The aim of this study was to assess the prognostic value of a battery of pretreatment biomarkers in the serum of patients with localized bone sarcomas and to adjust for potential confounders. MATERIAL AND METHODS: All patients diagnosed with localized intermediate and high-grade bone sarcoma during 1994 to 2008 were extracted from the Aarhus Sarcoma Registry. The serum levels of albumin, C-reactive protein, hemoglobin, neutrophils, lymphocytes, and sodium were collected from the patient records. The prognostic values of overall and disease-specific mortality were tested for each individual biomarker as well as for the Glasgow prognostic score (GPS) and for a new composite score incorporating five biomarkers (Aarhus composite biomarker score: ACBS). Adjustments were made for comorbidity as well as other possible prognostic factors, such as size, histological type, margin, chemotherapy, and soft tissue extension, using the Cox proportional hazard model. RESULTS: A total of 172 patients with high- or intermediate-grade localized bone sarcoma were included. Of these patients, 63 were diagnosed with chondrosarcoma and 109 patients with Ewing/osteosarcoma. The median age was 55 years for chondrosarcoma and 19 years for Ewing/osteosarcoma patients. The overall 5-year mortality was 31% [95% confidence interval (CI): 21-44] and 41% (95% CI: 33-51), whereas the 5-year disease-specific mortality was 21% (95% CI: 12-34) and 39% (95% CI: 31-49) for chondrosarcoma and Ewing/osteosarcoma, respectively. Comorbidities were present in 12% of the Ewing/osteosarcoma patients and in 24% of the chondrosarcoma patients. After adjustment for comorbidity and other confounders, it was found that elevated levels of CRP, low hemoglobin, low sodium, high GPS, and high ACBS were associated with increased overall mortality. Furthermore, elevated levels of CRP, low hemoglobin, high GPS, and high ACBS were associated with increased disease-specific mortality. CONCLUSION: Elevated levels of CRP, low hemoglobin, high GPS, and high ACBS were all independent prognostic factors for both overall and disease-specific mortality. ACBS is a new three-level score of five biomarkers, but its value has to be confirmed in an independent data set.

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“…[23] Cases of kidney, myocardium, rectum, ovary, retroperitoneum, and bladder involvement have been reported. [16101214]. …”

Section: Discussionmentioning

confidence: 99%

Peripheral primitive neuroectodermal tumor of the cervical spine

Cabral¹,

Nunes²,

Melo³

et al. 2012

Surg Neurol Int

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Background:Primitive neuroectodermal tumor (PNET) is a malignant neoplasm that generally arises from bone and soft tissues, with predilection for young adults. This neural crest origin tumors share biologic and histologic features with Ewing's sarcoma (ES).Case Description:We present a case of a 22-year-old woman with history of severe progressive neck pain, without radiation, associated with paresthesia in the right arm, and palpable right posterior cervical mass. Neurological examination showed increased reflexes in all four limbs, bilateral Hoffman's sign, right Babinski's sign, and right hemi-hypoesthesia. Neuroimaging revealed a right posterior cervical lesion with heterogeneous contrast enhancement extending to the neural foramina of the atlas and axis. Patient underwent microsurgical removal of the lesion, and histopathological and immunohistochemical analysis confirmed the diagnosis of peripheral primitive PNET (pPNET). The patient had adjuvant treatment with radiotherapy and chemotherapy. After twelve months, neuroimaging showed no signs of tumor regrowth and the patient had no neurological deficits. However, three months later, the patient developed hydrocephalus and cerebrospinal fluid (CSF) was positive for neoplastic cells. No other treatment was administered and the patient died.Conclusion:pPNET is a rare malignant tumor with poor prognosis, although promising results with multimodal treatment-surgery, radiotherapy, and chemotherapy. Diagnosis requires immunohistochemical analysis, with identification of neuronal differentiation markers.

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Long-Term Follow-Up and Prognostic Factors in Ewing’s Sarcoma

Cited by 45 publications

References 22 publications

Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literature

Pretreatment serum albumin as a predictor of cancer survival: A systematic review of the epidemiological literature

The Prognostic Value of Serum Biomarkers in Localized Bone Sarcoma

Peripheral primitive neuroectodermal tumor of the cervical spine

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