Risk Factors for Metastasis at Initial Diagnosis With Ewing Sarcoma

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.