The effect of surgery with radiation on pelvic Ewing sarcoma survival

Ng, Vincent Y.; Jones, Robin L.; Bompadre, Viviana; Louie, Philip K.; Punt, Stephanie; Conrad, Ernest U.

doi:10.1002/jso.24081

Cited by 20 publications

(10 citation statements)

References 45 publications

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“…Consistent with that hypothesis, the analysis of demographic characteristics in this study also identified age as an important prognostic factor for pelvic ES. The median age at diagnosis of patients with pelvic ES was 16 years, and as was consistent with previous studies (Lin et al, 2019; Ng et al, 2015), younger patients had more favorable survivals. Compared to patients of other races, white patients had a better survival (Davenport et al, 2016; Worch et al, 2010).…”

Section: Discussionsupporting

confidence: 89%

Characteristics and prognosis of pelvic Ewing sarcoma: a SEER population-based study

Chen¹,

Cheng²,

Liu³

et al. 2019

PeerJ

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Background The pelvis is one of the primary sites of Ewing sarcoma (ES) and is associated with poorer prognoses than the extremities. Due to the rarity of this disease and limited data available, the prognostic factors of pelvic ES remain controversial. Thus, this study aimed to identify independent prognostic factors, and develop a nomogram for predicting survival rates in patients with pelvic ES. Methods Using data provided by the Surveillance, Epidemiology, and End Results (SEER) database, variables including age, sex, race, tumor size, tumor stage, surgery, and radiotherapy were analyzed using the Kaplan–Meier method and Cox proportional hazards regression. Based on the results of multivariate analyses, a nomogram was built to predict the overall survival (OS) of patients with pelvic ES. The performance of the nomogram was evaluated by the concordance index (C-index). Results A total of 267 cases diagnosed between 2004 and 2016 were included in the study. Univariate and multivariate analyses showed that patients who were younger, white, had a localized tumor stage, or underwent surgery were associated with improved prognoses, while no significant differences were observed in OS based on sex, tumor size, or radiotherapy. A nomogram was developed and the C-index was 0.728, indicating adequate performance for survival prediction. Conclusions Age, race, tumor stage, and surgery were identified as independent prognostic factors for the OS of pelvic ES. The nomogram developed in this study can individually predict 3- and 5-year OS in patients with pelvic ES.

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Section: Discussionsupporting

confidence: 89%

Characteristics and prognosis of pelvic Ewing sarcoma: a SEER population-based study

Chen¹,

Cheng²,

Liu³

et al. 2019

PeerJ

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“…In landmark as well as in recent studies, improvement of local therapy has proven crucial in the treatment of advanced Ewing sarcoma patients [11, 20, 24], whereas the role of high-dose chemotherapy regimen with autologous stem cell transplantation in the treatment of advanced Ewing sarcoma patients remains subject to an ongoing discussion [4, 7, 10, 15–17, 25–35]. The conflicting results of various studies including our previous analyses [6, 20] in contrast to the results of Meyers et al [21] may be due to variation in intensity of local therapy.…”

Section: Discussionmentioning

confidence: 99%

Bone marrow involvement identifies a subgroup of advanced Ewing sarcoma patients with fatal outcome irrespective of therapy in contrast to curable patients with multiple bone metastases but unaffected marrow

et al. 2016

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PurposeAdvanced Ewing sarcomas have poor prognosis. They are defined by early relapse (<24 months after diagnosis) and/or by metastasis to multiple bones or bone marrow (BM). We analyzed risk factors, toxicity and survival in advanced Ewing sarcoma patients treated with the MetaEICESS vs. EICESS92 protocols.DesignOf 44 patients, 18 patients were enrolled into two subsequent MetaEICESS protocols between 1992 and 2014, and compared to outcomes of 26 advanced Ewing sarcoma patients treated with EICESS 1992 between 1992 and 1996. MetaEICESS 1992 consisted of induction chemotherapy, whole body imaging directed radiotherapy to the primary tumor and metastases, tandem high-dose chemotherapy and autologous rescue. In MetaEICESS 2007 this treatment was complemented by allogeneic stem cell transplantation. EICESS 1992 comprised induction chemotherapy, local therapy to the primary tumor only followed by consolidation chemotherapy.ResultsIn MetaEICESS 8/18 patients survived in complete remission vs. 2/26 in EICESS 1992 (p<0.05). Survival did not differ between MetaEICESS 2007 and MetaEICESS 1992. Three MetaEICESS patients died of complications, all in MetaEICESS 1992. After exclusion of patients succumbing to treatment related complications (n=3), 7/10 patients survived without BM involvement, in contrast to 0/5 patients with BM involvement. This was confirmed in a multivariate analysis. There was no correlation between BM involvement and the number of metastases at diagnosis.ConclusionThe MetaEICESS protocols yield long-term disease-free survival in patients with advanced Ewing sarcoma. Allogeneic stem cell transplantation was not associated with increased death of complications. Bone marrow involvement is a risk factor distinct from multiple bone metastases.

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“…We identified 878 studies and included 10 retrospective cohort or comparative studies in the review (5,(14)(15)(16)(17)(18)(19)(20)(21)(22)(23)(24). Figure 1 summarizes the flow diagram of the study retrieval and selection process.…”

Section: Eligible Studies and Quality Assessmentmentioning

confidence: 99%

Comparison of local control and survival outcomes between surgical and non-surgical local therapy on pelvic Ewing’s sarcoma patients: a meta-analysis

Xie¹,

Zeng²,

Yao³

et al. 2020

Transl Cancer Res TCR

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Background: The efficacy of surgical therapy to nonsurgical therapy is still a controversial topic in pelvic Ewing's sarcoma (ES) management. We perform a systemic review and meta-analysis to compare the effect of local control (LC) and survival outcomes between surgical and nonsurgical local therapy on pelvic ES patients with systemic chemotherapy.Methods: Published retrospective studies searched from PubMed, Embase, Cochrane and Web of Science databases that investigated the effects of surgical and nonsurgical local therapy on the LC and survival outcomes of patients with pelvic ES treated with chemotherapy were included in our study. Our primary outcome was the LC rate and progression-free survival (PFS) rate. The effect of confounders of extend of disease, surgical margin and chemotherapy respond on PFS was analyzed in subgroups.Results: Ten studies with 782 pelvic ES patients were included in our analysis. Surgical patients showed higher LC and PFS rate comparing to nonsurgical patients [LC: risk ratio (RR) 0.72, 95% CI: 0.52-1.00, P=0.05, I 2 =0%; PFS: RR 0.72, 95% CI: 0.61-0.86, P=0.000, I 2 =15%]. Localized patients showed higher PFS with surgical therapy than nonsurgical patients (RR 0.67, 95% CI: 0.51-0.88, P=0.003).Patients with adequate resection and good chemotherapy respond improved PFS comparing to nonsurgical patients (adequate resection vs. nonsurgical: RR 0.59, 95% CI: 0.46-0.76, P<0.001, I 2 =0%; good respond vs. nonsurgical: RR 0.56, 95% CI: 0.41-0.77, P<0.001, I 2 =21%). But patients with inadequate resection and poor chemotherapeutic respond shows no statistical different PFS comparing to nonsurgical patients (inadequate

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The effect of surgery with radiation on pelvic Ewing sarcoma survival

Abstract: Case-control or retrospective cohort study.

Cited by 20 publications

References 45 publications

Characteristics and prognosis of pelvic Ewing sarcoma: a SEER population-based study

Characteristics and prognosis of pelvic Ewing sarcoma: a SEER population-based study

Bone marrow involvement identifies a subgroup of advanced Ewing sarcoma patients with fatal outcome irrespective of therapy in contrast to curable patients with multiple bone metastases but unaffected marrow

Comparison of local control and survival outcomes between surgical and non-surgical local therapy on pelvic Ewing’s sarcoma patients: a meta-analysis

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