Surgical Resection of Primary Ewing’s Sarcoma of Bone Improves Overall Survival in Patients Presenting with Metastasis

Ren, Yingqing; Zhang, Zhida; Shang, Liyong; You, Xinmao

doi:10.12659/msm.913338

Cited by 15 publications

(12 citation statements)

References 34 publications

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“…The results of Kaplan-Meier curve showed that gender had no significant impact on OS, which was consistent with that of S.E. Bosma, Friedman Danielle Novetsky and Ren Yingqing et al [3,4,7], who found that female patients with Ewing sarcoma had similar OS to male patients. In the process of developing the nomogram, we found that age played a pivotal role in total points.…”

Section: Discussionsupporting

confidence: 88%

“…3 Nomogram for the prediction of 3-and 5-year OS in patients with Ewing sarcoma. OS, overall survival of other studies [3][4][5][6], except S.E. Bosma et al, who indicated by a system review that the level of evidence for an association with OS for age was inconclusive.…”

Section: Discussionmentioning

confidence: 96%

“…There are several clinical parameters influencing the survival of patients with Ewing sarcoma. Age, tumor stage, tumor location, metastatic disease, chemotherapy and surgery have been found to have impacts on overall survival (OS) in patients with Ewing sarcoma [2][3][4][5][6][7]. The aim of this study is to integrate prognostic parameters into analysis and predict outcomes in patients with Ewing sarcoma.…”

Section: Introductionmentioning

confidence: 99%

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A nomogram for predicting overall survival in patients with Ewing sarcoma: a SEER-based study

Zhou

Wang

Fang

et al. 2020

BMC Musculoskelet Disord

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Background Ewing sarcoma, the second most frequent bone tumor in children and adolescents, is often presented with localized disease or metastatic-related symptoms. In this study, we aim to construct and validate a nomogram for patients with Ewing sarcoma to predict the 3- and 5-year overall survival (OS) based on the Surveillance, Epidemiology, and End Results (SEER) database. Methods Demographic and clinic pathological characteristics of patients with Ewing sarcoma diagnosed between 2010 and 2015 were extracted from SEER database. Univariate and multivariate Cox analyses were carried out to identify the independent characteristics. The independent factors were further included into the construction of a nomogram. Finally, c-index and calibration curves were used to validate the nomogram. Results A total of 578 patients were enrolled into our analysis. The results of univariate Cox analysis showed that age, 7th AJCC stage, 7th AJCC T stage, 7th AJCC N stage, 7th AJCC M stage, metastatic status to lung, liver and bone were significant factors. Multivariate Cox analysis was performed and it confirmed age, N stage and bone metastasis as independent variables. Next, a nomogram was constructed using these independent variables in prediction to the 3- and 5-year OS. Furthermore, favorable results with c-indexes (0.757 in training set and 0.697 in validation set) and calibration curves closer to ideal curves indicated the accurate predictive ability of this nomogram. Conclusions The individualized nomogram demonstrated a good ability in prognostic prediction for patients with Ewing sarcoma.

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Section: Discussionsupporting

confidence: 88%

Section: Discussionmentioning

confidence: 96%

Section: Introductionmentioning

confidence: 99%

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A nomogram for predicting overall survival in patients with Ewing sarcoma: a SEER-based study

Zhou

Wang

Fang

et al. 2020

BMC Musculoskelet Disord

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“…In line with past research and recent unpublished data and conference abstracts, we observed that surgical resection of the primary tumor was associated with an overall survival benefit for patients presenting with metastatic primary malignant bone tumors. Using the national SEER database, Ren et al [28] found that surgical resection of primary tumors in patients with metastatic Ewing sarcoma was associated with substantially improved overall survival. Two additional SEER-based abstracts presented at the 2019 Musculoskeletal Tumor Society (MSTS) meeting found that surgical resection of the primary tumor site improves survival for both patients with metastatic osteosarcoma and those with soft-tissue sarcomas.…”

Section: Surgical Resection Of the Primary Tumor And Overall Survivalmentioning

confidence: 99%

Is Surgical Resection of the Primary Site Associated with an Improved Overall Survival for Patients with Primary Malignant Bone Tumors Who Have Metastatic Disease at Presentation

2021

OrthoMedia

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Background The management of primary malignant bone tumors in patients with metastatic disease at presentation remains a challenge. Although surgical resection has been a mainstay in the management of nonmetastatic malignant bone tumors, there is a lack of large-scale evidence-based guidance on whether surgery of the primary site/tumor improves overall survival in malignant bone tumors with metastatic disease at presentation. Questions/purposes (1) Is surgical resection of the primary tumor associated with improved overall survival in patients with primary malignant bone tumors who have metastatic disease at presentation? (2) What other factors are associated with improved and/or poor overall survival? Methods The 2004 to 2016 National Cancer Database (NCDB), a national registry containing data from more than 34 million cancer patients in the United States, was queried using International Classification of Diseases, 3rd Edition, topographical codes to identify patients with primary malignant bone tumors of the extremities (C40.0-C40.3, C40.8, and C40.9) and/or pelvis (C41.4). The NCDB was preferred over other national cancer registries (that is, the Surveillance, Epidemiology, and End Results database) because it includes a specific variable that codes for patients who received additional surgeries at metastatic sites. Patients with malignant bone tumors of the head or skull, trunk, and spinal column were excluded because these patients are not routinely encountered and treated by orthopaedic oncologists. Histologic codes were used to categorize the tumors into the following groups: osteosarcomas, chondrosarcomas, and Ewing sarcomas. Patients whose tumors were classified as Stage 1, 2, or 3 based on American Joint Commission of Cancer guidelines were excluded. Only patients who presented with metastatic disease were included in the final study sample. The study sample was divided into two distinct groups: those who underwent surgical resection of the primary tumor and those who did not receive any operation for the primary tumor. A total of 2288 patients with primary malignant bone tumors (1121 osteosarcomas, 345 chondrosarcomas, and 822 Ewing sarcomas) with metastatic disease at presentation were included, of whom 46% (1053 of 2288) underwent surgical resection of the primary site. Thirty-three percent (348 of 1053) of patients undergoing surgical resection of the primary site also underwent additional resection of metastases. Patients undergoing surgical Each author certifies that neither he, nor any member of his immediate family, has funding or commercial associations (consultancies, stock ownership, equity interest, patent/licensing arrangements, etc) that might pose a conflict of interest in connection with the submitted article. Each author certifies that his institution waived approval for the human protocol for this investigation and that all investigations were conducted in conformity with ethical principles of research.

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“…For patients with metastatic ES, surgical treatment is also signi cant for the survival rate [41] . This is consistent with the results of this study, although the effect of tumor site and size on prognosis is complex.…”

Section: Establishment and Veri Cation Of Survival Analysis And Predimentioning

confidence: 99%

Establishment of a Risk Factor and Clinical Prediction Model for Distal Metastasis and Prognosis of Ewing Sarcoma: A SEER-Based Study

Li¹,

Hu²,

wang³

et al. 2020

Preprint

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Background: the purpose of this study was to establish and validate a clinical predictive model for predicting the risk of metastasis and survival of patients with Ewing sarcoma. Methods: the data of patients diagnosed with Ewing' sarcoma (ES) from 2004 to 2015 were collected from the Surveillance, Epidemiology and final results Database (The Surveillance, Epidemiology, and End Results, SEER). By excluding vacancy data and random number method, the screened data were divided into training set (nasty 2520) and verification set (nasty 1076). Logistic regression analysis was used to analyze the risk factors related to tumor metastasis, and Kaplan-Meier curve and Cox proportional hazard model were used to explore the related risk factors affecting patient survival. A visual line chart (Nomogram) based on the above analysis was developed to predict ES tumor metastasis and patient's 3-and 5-year survival probability, and to verify it. Results: in the analysis of tumor metastasis, it was found that age over 60 years old, operation, tumor volume, radiotherapy and chemotherapy were the high risk factors of tumor metastasis. The establishment of Nomogram, to predict the risk of tumor metastasis and the use of ROC curve showed that the predictive model had better predictive ability (AUC=0.744,95%CI0.721-0.768), which could predict the existence of tumor metastasis. In the survival analysis of the training set, age (20-29, 30-60, > 60), location of tumor (axial, bone, facial bone), mode of operation (local excision, radical resection), number of primary tumor (multiple), tumor stage M (M 1,), Stage Group (II,III,IV,UNK stage), tumor volume (5 cm 10 cm, greater than 10cm), spread range (local metastasis). Distal metastasis), radiotherapy and chemotherapy are independent prognostic factors of patients. The Nomogram, established to predict 3 years and 5 years of patients is verified by the verification set, which shows a good consistency (c index = 0.747, 95% CI, 0.696-0.797).Conclusion: Nomogram with good predictive ability is developed to predict the risk of tumor metastasis and the 3-and 5-year survival rate of patients with ES. External data validation is still needed in future clinical applications, especially outside the United States.

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Surgical Resection of Primary Ewing’s Sarcoma of Bone Improves Overall Survival in Patients Presenting with Metastasis

Cited by 15 publications

References 34 publications

A nomogram for predicting overall survival in patients with Ewing sarcoma: a SEER-based study

A nomogram for predicting overall survival in patients with Ewing sarcoma: a SEER-based study

Is Surgical Resection of the Primary Site Associated with an Improved Overall Survival for Patients with Primary Malignant Bone Tumors Who Have Metastatic Disease at Presentation

Establishment of a Risk Factor and Clinical Prediction Model for Distal Metastasis and Prognosis of Ewing Sarcoma: A SEER-Based Study

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