Treatment and survival of osteosarcoma and Ewing sarcoma of the skull: a SEER database analysis

Abstract

Background Common primary bone tumors include osteosarcomas (OSC) and Ewing sarcomas (EWS). The skull is a rare site, and literature about their treatment and survival is scarce. Using the Surveillance, Epidemiology, and End Results (SEER) database, this study aims to assess the treatment and survival of skull OSC and skull EWS, as well as predictors for survival. Methods Skull OSC and EWS cases were obtained from the SEER database. Patient and tumor characteristics, treatment modalities, and survival were extracted. Overall survival (OS) was assessed using multivariable Cox proportional hazard regression stratified by tumor histology. Kaplan-Meier curves were constructed for OS comparing OSC and EWS, as well as histological subtypes in OSC. Results A total of 321 skull OSC and 80 skull EWS patients were registered from 1973 to 2013. EWS was more common in younger patients ( p < 0.001). Resection was the predominant treatment strategy (80.1%), frequently in combination with adjuvant radiotherapy (30.4%). The 5-year survival rate varied significantly between OSC and EWS (51.0% versus 68.5%, p = 0.02). Kaplan-Meier curves show that EWS had a significantly better survival compared to OSC. Comparing histological subtypes of skull OSC, chondroblastic OSC had the best OS, Paget OSC the worst. Older age, tumor advancement, no surgical treatment, and the use of radiotherapy were identified as independent predictors of decreased OS in skull OSC. Conclusion Overall prognosis is better for EWS compared to OSC. Chondroblastic OSC have the best overall survival, while OSC associated with Paget’s disease of the bone has the poorest overall survival.

The Na+/K+ ATPase Inhibitor Ouabain Attenuates Stemness and Chemoresistance of Osteosarcoma Cells

“…It is often found in the metaphysis of long bones and is often accompanied by lung metastasis in the early stage [1]. With traditional treatment strategies, including radical limb salvage surgery, pre-operative neoadjuvant chemotherapy and post-operative multi-drug combination chemotherapy, the 5-year survival rate is only 50–70% for patients with small primary tumors and their treatment is far from ideal, perhaps due to the complex mechanisms contributing to OS occurrence [2]. Therefore, it is necessary to elucidate the mechanism of OS occurrence.…”

Entrapment of the Greater Occipital Nerve with Chronic Migraine and Severe Facial Pain: A Case Report

“…Patients with primary localized Ewing's sarcoma treated at the Mayo Clinic between 1950 and 1968 had only a 21.8% probability of surviving for longer than 5 years, while currently the 5-year survival rate for patients treated with complete surgical excision, chemotherapy, and irradiation may be as high as 74%. 1 Other large series reported a 2-year disease-free survival rate of 50 to 80% after treatment. 16 The presence of metastases and tumor location are considered the most important prognostic factors.…”

“…It usually occurs in the first and second decades of life and mainly involves the long bones of the extremities, pelvis, and ribs. 1,2 Primary Ewing's sarcoma of the skull is very rare, occurring in only $1% of cases. 3,4 We describe here the clinical, neuroradiologic, and histopathologic features of a patient with primary Ewing's sarcoma of the skull and discuss the therapy for this type of tumor.…”

“…Long-term follow-up of larger numbers of patients is required to prove that Ewing's sarcoma of the skull bone has a different prognosis to this lesion in other locations, although case reports and retrospective series of cases strongly suggest this conclusion. 1,2,6 Conflict of Interest None declared.…”

Primary osteosarcoma of the skull in teenager

“…Surgery involving total resection of the primary lesion including a large tumour-free margin of bone tissue and systemic chemotherapy are considered as the treatment of choice 22. The use of radiotherapy remains controversial.…”