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Prognostic factors for overall survival in paediatric patients with Ewing sarcoma of bone treated according to
J L López Guerra1, C Márquez-Vega, G L Ramírez-Villar
1Department of Radiation Oncology, The University of Texas M.D. Anderson Cancer Center, Houston, TX 77030, USA. chanodetriana@yahoo.es
Insights
Prognostic factors for bone Ewing sarcoma (EWS) in pediatric patients include older age, incomplete response to treatment, larger tumor volume, and distant recurrences. These factors are crucial for stratifying patients and developing targeted therapies.
Area of Science:
- Pediatric Oncology
- Skeletal Tumors
- Cancer Research
Background:
- Ewing sarcoma (EWS) is a rare bone cancer primarily affecting children and adolescents.
- Understanding prognostic factors is essential for improving patient outcomes in EWS.
Purpose of the Study:
- To evaluate the outcomes of patients diagnosed with bone Ewing sarcoma (EWS).
- To identify significant prognostic factors influencing survival in pediatric EWS patients.
Main Methods:
- Retrospective analysis of 77 patients under 18 diagnosed with bone EWS between 1979 and 2009.
- Patients received one of four chemotherapy protocols, with local treatment including surgery, radiotherapy, or both.
- Multivariate analysis was employed to identify independent predictors of mortality.
Main Results:
- The median age at diagnosis was 10 years; median follow-up was 8.6 years.
- Overall survival rates were 70% at 2 years and 51% at 5 years.
- Independent predictors of death included age ≥14 years, lack of complete response, tumor volume ≥150 ml, and distant recurrences.
Conclusions:
- Patient outcomes in bone EWS are significantly influenced by clinical and treatment-related variables.
- Prognostic stratification criteria should incorporate identified significant variables.
- Future therapies should focus on high-risk patient groups identified through these prognostic factors.
Background:
The purpose of this study is to assess the outcome of patients with Ewing sarcoma (EWS) of the bone and to identify prognostic factors.
Materials And Methods:
Seventy-seven patients younger than 18 years old, diagnosed with EWS of the bone between 1979 and 2009, were analysed retrospectively. Four different protocols of chemotherapy were used successively. Local treatment consisted of surgery (N=32), radiotherapy (N=20) and a combination of both (N=19).
Results:
The median age at diagnosis was 10 years old (range, 2-17) and the median follow-up for survivors 8.6 years (range, 1-18.8). Thirty-two relapses occurred (21 distant, 5 local and 6 both). The 2- and 5-year overall survival rates were 70% and 51%, respectively. Multivariate analysis showed four significant independent predictors for death: age ≥14 years old (HR: 5.06; p=0.019), lack of complete response (HR: 8.04; p<0.001), tumour volume ≥150 ml (HR: 2.21; p=0.045) and distant recurrences (HR: 1.45; p=0.001).
Conclusions:
Outcome of EWS of bone is influenced by many clinical and treatment-correlated variables. Criteria to stratify patients should include all the variables that have shown prognostic significance. The development of novel therapies should target these high-risk groups.
