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Risk Factors for Metastasis at Initial Diagnosis With Ewing Sarcoma.

Conglin Ye1, Min Dai1, Bin Zhang1

  • 1Department of Orthopedics, Artificial Joints Engineering and Technology Research Center of Jiangxi Province, The First Affiliated Hospital of Nanchang University, Nanchang, China.

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|November 5, 2019
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Summary

Adults aged 18-59 diagnosed with Ewing sarcoma, especially those with axial/cranial bone tumors or large tumors (>8cm), face a higher risk of metastasis at diagnosis. Lung metastasis alone indicates a better prognosis.

Keywords:
Ewing sarcomaSEERmetastatic diseasesurvivaltumor size

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Area of Science:

  • Pediatric Oncology
  • Medical Imaging
  • Biostatistics

Background:

  • Ewing sarcoma is a rare bone cancer primarily affecting children and young adults.
  • Metastasis at initial diagnosis significantly impacts prognosis and treatment strategies.
  • Identifying predictive risk factors is crucial for early intervention.

Purpose of the Study:

  • To identify demographic and clinical risk factors associated with metastasis at initial diagnosis in Ewing sarcoma patients.
  • To analyze the predictive value of age, tumor location, and tumor size for distant metastasis.
  • To compare survival outcomes based on metastatic sites.

Main Methods:

  • Retrospective analysis of 1,066 Ewing sarcoma patients from the SEER database (2004-2015).
  • Descriptive statistics, univariate and multivariate logistic regression models to assess risk factors.
  • Kaplan-Meier analysis for survival comparison across different metastatic sites.

Main Results:

  • 31.1% of patients presented with metastasis at initial diagnosis.
  • Age 18-59 (OR=1.43), axial/cranial bone tumor location (OR=1.38), and tumor size >8 cm (OR=2.55) were significant predictors of metastasis.
  • Patients with lung metastasis alone had a better prognosis than those with bone metastasis or multiple metastatic sites (p<0.01).

Conclusions:

  • Ewing sarcoma patients aged 18-59, with axial/cranial bone tumors, or tumors >8 cm have a higher likelihood of metastatic disease at diagnosis.
  • These factors are critical for risk stratification and treatment planning.
  • Understanding metastatic patterns aids in tailoring prognostic assessments.