Complications in long-term survivors of Ewing sarcoma

Multimodality treatment has dramatically improved the outcome of patients with Ewing sarcoma. However, there appears to be little information concerning treatment-related complications in patients who are long-term survivors.

Forty-one patients with Ewing sarcoma who were treated between 1960-1980 and who survived the disease by at least 20 years were included in the current study. In a retrospective analysis, all complications related to the multimodality treatment of Ewing sarcoma were assessed.

The patient group was comprised of 17 men and 24 women, with a mean age at the time of presentation of 16.8 years (range, 5-51 years). Approximately 20% of the lesions were located in the pelvis. All but 9 patients (78%) received chemotherapy as part of their treatment. The overall follow-up period averaged 25 years (range, 20-36 years). All except 1 patient were alive at the time of final follow-up, with the latter patient dying of radiation-induced secondary malignancy after 33 years. Only 17 patients (41%) were found to be free of any complication. These included metastases, local recurrence, secondary malignancies, pathologic fractures, and radiation-associated and chemotherapy-associated morbidities.

Although the patients in the current study were treated successfully in terms of surviving an aggressive tumor, the high complication rate in this group of long-term survivors is noteworthy and indicates that long-term follow-up should be mandatory.