Recurrence of Ewing sarcoma: Is detection by imaging follow‐up protocol associated with survival advantage?

Heinemann, Melina; Ranft, Andreas; Langer, Thor﻿s﻿ten; Jürgens, H.; Kreyer, Justus; Vieth, Volker; Schäfers, Michael; Weckesser, Matthias; Simon, Thorsten; Hassenpflug, Wolf; Corbacioglu, Selim; Bielack, Stefan; Mayer-Steinacker, Regina; Kühne, Thomas; Berg, Henk van den; Gelderblom, Hans; Bauer, Sebastian; Stegger, Lars; Dirksen, Uta

doi:10.1002/pbc.27011

Cited by 24 publications

(24 citation statements)

References 25 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…[21][22][23] The current study is limited by its retrospective design. [21][22][23] The current study is limited by its retrospective design.…”

Section: Discussionmentioning

confidence: 99%

“…Recent studies assessing the value of routine imaging in other soft-tissue and bone sarcomas have shown contradictory results, and this illustrates the necessity for tumorspecific studies assessing the value of surveillance imaging because its value is dependent on tumor-specific factors (eg, tumor biology and chance of survival after relapse). [21][22][23] The current study is limited by its retrospective design. We tried to limit this bias by using a standardized case report form.…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Is surveillance imaging in pediatric patients treated for localized rhabdomyosarcoma useful? The European experience

Vaarwerk

Mallebranche

Affinita

et al. 2019

Cancer

View full text Add to dashboard Cite

BACKGROUND: After the completion of therapy, patients with localized rhabdomyosarcoma (RMS) are subjected to intensive radiological tumor surveillance. However, the clinical benefit of this surveillance is unclear. This study retrospectively analyzed the value of off-therapy surveillance by comparing the survival of patients in whom relapse was detected by routine imaging (the imaging group) and patients in whom relapse was first suspected by symptoms (the symptom group). METHODS: This study included patients with relapsed RMS after the completion of therapy for localized RMS who were treated in large pediatric oncology hospitals in France, the United Kingdom, Italy, and the Netherlands and who were enrolled in the International Society of Paediatric Oncology Malignant Mesenchymal Tumor 95 (1995)(1996)(1997)(1998)(1999)(2000)(2001)(2002)(2003)(2004) study, the Italian Paediatric Soft Tissue Sarcoma Committee Rhabdomyosarcoma 96 (1996-2004) study, or the European Paediatric Soft Tissue Sarcoma Study Group Rhabdomyosarcoma 2005 (2005-2013) study. The survival times after relapse were compared with a log-rank test between patients in the imaging group and patients in the symptom group. RESULTS: In total, 199 patients with relapsed RMS were included: 78 patients (39.2%) in the imaging group and 121 patients (60.8%) in the symptom group. The median follow-up time after relapse was 7.4 years (interquartile range, 3.9-11.5 years) for survivors (n = 86); the 3-year postrelapse survival rate was 50% (95% confidence interval [CI], 38%-61%) for the imaging group and 46% (95% CI, 37%-55%) for the symptom group (P = .7). CONCLUSIONS: Although systematic routine imaging is the standard of care after RMS therapy, the majority of relapses were detected as a result of clinical symptoms. This study found no survival advantage for patients whose relapse was detected before the emergence of clinical symptoms. These results show that the value of off-therapy surveillance is controversial, particularly because repeated imaging may also entail potential harm. Cancer 2020;126:823-831.

show abstract

“…[21][22][23] The current study is limited by its retrospective design. [21][22][23] The current study is limited by its retrospective design.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Is surveillance imaging in pediatric patients treated for localized rhabdomyosarcoma useful? The European experience

Vaarwerk

Mallebranche

Affinita

et al. 2019

Cancer

View full text Add to dashboard Cite

show abstract

“…6,114 At the time of relapse, about 52% of patients have symptoms, while remaining patients are diagnosed during follow-up imaging. 117 The most important prognostic factors are interval between initial diagnosis and subsequent relapse, and site of relapse. Other prognostic factors for poor survival at relapse include high LDH at relapse, age >15 years, nonpulmonary metastasis and symptomatic relapse.…”

Section: Ewing Sarcoma [Ews]/primitive Neuroectodermal Tumor [Pnet]mentioning

confidence: 99%

<p>Management of Refractory Pediatric Sarcoma: Current Challenges and Future Prospects</p>

Pushpam¹,

Garg²,

Ganguly³

et al. 2020

OTT

View full text Add to dashboard Cite

Paediatric sarcomas are a heterogeneous group of disorders constituting bone sarcoma and various soft tissue sarcomas. Almost one-third of these presents with metastasis at baseline and another one-third recur after initial curative treatment. There is a huge unmet need in this cohort in terms of curative options and/or prolongation of survival. In this review, we have discussed the current treatment options, challenges and future strategies of managing relapsed/ refractory paediatric sarcomas. Upfront risk-adapted treatment with multidisciplinary management remains the main strategy to prevent future recurrence or relapse of the disease. In the case of limited local and/or systemic relapse or late relapse, initial multimodality management can be administered. In treatment-refractory cases or where cure is not feasible, the treatment options are limited to novel therapeutics, immunotherapeutic approach, targeted therapies, and metronomic therapies. A better understanding of disease biology, mechanism of treatment refractoriness, identifications of driver mutation, the discovery of novel targeted therapies, cellular vaccine and adapted therapies should be explored in relapsed/refractory cases. Close national and international collaboration for translation research is needed to fulfil the unmet need.

show abstract

“…Different opinions about whether surgical margin and recurrence affect metastasis and survival [22,23]. Some studies suggested safe surgical margin only affects recurrence, and recurrence didn't increase metastasis and reduce survival [24][25][26]. However, more studies suggested the risk of local recurrence was leading to metastasis and reducing survival [6,27,28].…”

Section: Discussionmentioning

confidence: 99%

What Are the Results of Limb Salvage Surgery for Primary Malignant Bone Tumor in the Forearm?

Liu

Yang

Jin

et al. 2020

Preprint

View full text Add to dashboard Cite

Background The forearm primary malignant bone tumor is rare and limb salvage is difficult. The purpose of this study was to analyze epidemiological characteristics of forearm primary malignant bone tumors and to explore oncological and functional results of limb salvage surgery in forearm.Methods 369 patients with primary forearm malignant bone tumors were retrospectively analyzed from 2000 to 2017. There were 266 patients with radius tumor and 46 (17.3%) of them were malignancy, while 103 patients with ulna lesion and 22 (21.4%) of them were malignant tumor. The oncological results, prognostic factors and functional results after limb salvage surgery of forearm malignancy were analyzed.Results A total of 60 patients received limb salvage surgery. Fifty-six patients followed more than 12 months or progressions within 12 months were included in final evaluation. Radius resection was performed in 38 patients and distal radius (25 patients) was most frequent. Ulna resection was performed in 18 patients and proximal ulna (13 patients) was most frequent. The surgical margin contained intracapsular resection in 3 patients, marginal resection in 8 patients and wide resection in 45 patients. The follow-up averaged 72.1 (7-192, median 62.5) months. Local recurrence occurred in 11 patients (19.6%) and distant metastasis occurred in 14 patients (25%). The 5-year recurrence free survival rates was 79.8%. Univariate analysis showed history of unplanned resection, tumor located in ulna, tumor located in proximal forearm and inadequate surgical margin were associated with recurrence. The overall 5-year and 10-year survival rates were 83.5% and 71.7%, respectively. Univariate analysis showed inadequate surgical margin, local recurrence and distant metastasis were associated with death. Forty-two patients were evaluated by MSTS score with an average of (93.0 ± 5.1) %.Conclusions The incidence of radius malignant tumor is higher than that of ulna. The distal radius and proximal ulna are most frequency involved sites. Unplanned resection, tumor located in ulna, tumor located in proximal forearm and inadequate surgical margin are risk factors for local recurrence; local recurrence and distant metastasis are independent prognostic factors of death. The oncology control and function result of limb salvage surgery was satisfactory.

show abstract

Recurrence of Ewing sarcoma: Is detection by imaging follow‐up protocol associated with survival advantage?

Abstract: FUIP may benefit survival in EwS relapse, especially in lung recurrence. Pain was the leading symptom of relapse.

Cited by 24 publications

References 25 publications

Is surveillance imaging in pediatric patients treated for localized rhabdomyosarcoma useful? The European experience

Is surveillance imaging in pediatric patients treated for localized rhabdomyosarcoma useful? The European experience

<p>Management of Refractory Pediatric Sarcoma: Current Challenges and Future Prospects</p>

What Are the Results of Limb Salvage Surgery for Primary Malignant Bone Tumor in the Forearm?

Contact Info

Product

Resources

About