Time to Diagnosis of Ewing Tumors in Children and Adolescents Is Not Associated With Metastasis or Survival: A Prospective Multicenter Study of 436 Patients

Brasme, Jean-François; Chalumeau, Martin; Oberlin, Odile; Valteau‐Couanet, Dominique; Gaspar, Nathalie

doi:10.1200/jco.2013.53.8058

Cited by 59 publications

(62 citation statements)

References 26 publications

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“…Pending such confirmatory efforts, we judge it appropriate to attempt a discussion on the practical implications of our findings. When some authors of earlier studies found no correlation between time to diagnosis and outcome, they concluded that efforts to reduce the symptom interval could yield psychological benefits at most, not a substantially better prognosis . We consider such a claim potentially dangerous.…”

Section: Discussionmentioning

confidence: 99%

The Sooner the Better? How Symptom Interval Correlates With Outcome in Children and Adolescents With Solid Tumors: Regression Tree Analysis of the Findings of a Prospective Study

Ferrari

Vullo

Giardiello

et al. 2015

Pediatr Blood Cancer

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Background. The potential impact of diagnostic delays on patients' outcomes is a debated issue in pediatric oncology and discordant results have been published so far. We attempted to tackle this issue by analyzing a prospective series of 351 consecutive children and adolescents with solid malignancies using innovative statistical tools. Methods. To address the nonlinear complexity of the association between symptom interval and overall survival (OS), a regression tree algorithm was constructed with sequential binary splitting rules and used to identify homogeneous patient groups vis-à-vis functional relationship between diagnostic delay and OS. Results. Three different groups were identified: group A, with localized disease and good prognosis (5-year OS 85.4%); group B, with locally or regionally advanced, or metastatic disease and intermediate prognosis (5-year OS 72.9%), including neuroblastoma, Wilms tumor, nonrhabdomyosarcoma soft tissue sarcoma, and germ cell tumor; and group C, with locally or regionally advanced, or metastatic disease and poor prognosis (5-year OS 45%), including brain tumors, rhabdomyosarcoma, and bone sarcoma. The functional relationship between symptom interval and mortality risk differed between the three subgroups, there being no association in group A (hazard ratio [HR]: 0.96), a positive linear association in group B (HR: 1.48), and a negative linear association in group C (HR: 0.61). Conclusions. Our analysis suggests that at least a subset of patients can benefit from an earlier diagnosis in terms of survival. For others, intrinsic aggressiveness may mask the potential effect of diagnostic delays. Based on these findings, early diagnosis should remain a goal for pediatric cancer patients. Pediatr Blood Cancer 2016;63:479-485. C 2015Wiley Periodicals, Inc.

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Section: Discussionmentioning

confidence: 99%

The Sooner the Better? How Symptom Interval Correlates With Outcome in Children and Adolescents With Solid Tumors: Regression Tree Analysis of the Findings of a Prospective Study

Ferrari

Vullo

Giardiello

et al. 2015

Pediatr Blood Cancer

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“…Time to diagnosis is one of the longest as compared to other pediatric tumors; however, it is not associated with worsened prognosis. [7] The most frequent sites of origin in decreasing order of the prevalence include the paravertebral region, lower extremity, chest wall, retroperitoneum, pelvis, and hip. [7] The lung is the most common site of metastatic spread.…”

Section: Discussionmentioning

confidence: 99%

“…[7] The most frequent sites of origin in decreasing order of the prevalence include the paravertebral region, lower extremity, chest wall, retroperitoneum, pelvis, and hip. [7] The lung is the most common site of metastatic spread. [8]…”

Section: Discussionmentioning

confidence: 99%

Vaginal Ewing Sarcoma: An Uncommon Clinical Entity in Pediatric Patients

Cross

Stanescu

Rudzinski

et al. 2017

Journal of Clinical Imaging Science

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Ewing sarcoma, including classical Ewing sarcoma of the bone and primitive neuroectodermal tumors arising in bone or extraosseous primary sites, is a highly aggressive childhood neoplasm. We present two cases of Ewing sarcoma arising from the vagina in young girls. Previously reported cases in literature focused on their pathologic rather than radiographic features. We describe the spectrum of multimodality imaging appearances of Ewing sarcoma at this unusual primary site. Awareness of vaginal Ewing tumors may facilitate prompt diagnosis and lead to a different surgical approach than the more commonly encountered vaginal rhabdomyosarcoma.

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“…Recently, Brasme et al 11 analysed the effect of time to diagnosis of Ewing's tumours on metastasis and survival, in children and adolescents. Their prospective study of 436 patients with Ewing's sarcoma showed that survival was not significantly associated with time to diagnosis, though the authors acknowledge the psychological toll of a delayed diagnosis.…”

Section: Discussionmentioning

confidence: 99%

Is time of the essence? Delayed diagnosis of Ewing's sarcoma

et al. 2015

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Rarely in modern medicine are we able to observe the natural history of a patient with a sarcoma. This unusual case provides that opportunity. A CT scan was performed on the leg of a 15-year-old boy with a tender soft tissue mass on the lateral aspect of his left calf. Despite showing a lesion consistent with a sarcoma, neither the patient nor his family was informed. Almost a year and a half later, the patient returned and was diagnosed with Ewing's sarcoma. A staging work up showed no metastatic disease. After undergoing chemotherapy and a complete surgical resection of the tumour, the patient remains disease-free 10 years later, indicating that the biology of Ewing's sarcoma may be more important than time to diagnosis in determining outcome.

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Time to Diagnosis of Ewing Tumors in Children and Adolescents Is Not Associated With Metastasis or Survival: A Prospective Multicenter Study of 436 Patients

Cited by 59 publications

References 26 publications

The Sooner the Better? How Symptom Interval Correlates With Outcome in Children and Adolescents With Solid Tumors: Regression Tree Analysis of the Findings of a Prospective Study

The Sooner the Better? How Symptom Interval Correlates With Outcome in Children and Adolescents With Solid Tumors: Regression Tree Analysis of the Findings of a Prospective Study

Vaginal Ewing Sarcoma: An Uncommon Clinical Entity in Pediatric Patients

Is time of the essence? Delayed diagnosis of Ewing's sarcoma

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