Prognostic significance of tumor volume in localized Ewing's sarcoma of bone in children and adolescents

Abstract

A total of 60 consecutive patients with localized Ewing's sarcoma of bone who were entered into the Cooperative Ewing's Sarcoma Study of the German Society of Pediatric Oncology from January 1981 until April 1985 were evaluable for tumor volume at diagnosis. The tumor volume was calculated from plain X-rays and CT scans as ellipsoidal or cylindrical depending on the tumor configuration and presence or absence of a soft tissue component. The 3-year disease-free survival rate according to Kaplan-Meier life table analysis was 78% for tumors with a volume less than 100 ml compared to 17% for tumors greater than or equal to 100 ml volume. These results were independent of the site of the tumor, though larger tumors were primarily located in central and proximal extremity sites. Maximal tumor extension was less precise than tumor volume in predicting prognosis. The ratio of tumor volume to body surface area, body length, or body weight did not increase the ability to separate prognostic groups compared to tumor volume. The better prognosis for patients following radical surgery seems to be in part due to a biased distribution of tumor volumes within local therapy groups, since more patients with smaller tumors had surgery for local control.

Treatment of nonmetastatic Ewing’s sarcoma family tumors of the spine and sacrum: the experience from a single institution

“…In contrast with the results observed for other locations [4,6,7,9,[12][13][14][15][16]19], the outcome for our series was unrelated to tumor volume, type of local treatment, histology (ES vs. PNET), LDH serum levels, and neoadjuvant chemotherapy protocols.…”

Toxicity of high-dose chemotherapy with etoposide, thiotepa and CY in treating poor-prognosis Ewing's sarcoma family tumors: the experience of the Bambino Gesù Children's Hospital

“…An EFS of 70% was achieved for patients with localized disease, and OS reached 80%. [4][5][6][7][8][17][18][19][20][21] The outcome of metastatic patients remains dismal, especially for patients with bone and BM involvement. [4][5][6][9][10][11] Rodriguez Galindo et al 23 suggested risk stratification, taking into account simple clinical features, such as age, stage, tumor volume, localization and histological response to chemotherapy, to modulate treatment intensification in different subgroups.…”

“…[1][2][3] In the past decade, ESFT outcome was improved largely through a multidisciplinary strategy based on surgery, radiotherapy and intensified chemotherapy regimens, [4][5][6] whereas large studies have identified risk factors associated with the worse prognosis. [4][5][6][7][8] Since the late 1980s, high-dose chemotherapy (HDC), followed by stem-cell rescue, has been proposed to improve the outcome of patients with poor-prognosis ESFT. Although many studies have been published, the role of HDC in ESFT remains unclear.…”

Clinical and imaging observations of desmoid tumors left without treatment

“…At MRI, tumor diameters were measured in 3 planes: transverse, sagittal and coronal. The tumor volume was calculated according to Göbel et al (1987) and then plotted as a function of time (Figures 1 and 2).…”