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Prognostic Factors and Clinical Outcomes in Extraskeletal Ewing Sarcoma: A Cohort Study
Joseph Mathew1, Ravi Arjunan2, Ashwathappa Dasappa2
1Department of Surgical Oncology, Kidwai Memorial Institute of Oncology, Bangalore, India. drjosephmathew89@gmail.com.
Annals of Surgical Oncology
|December 23, 2022
Summary
For extraskeletal Ewing sarcoma (ESE), chemotherapy before local treatment is recommended unless the tumor is clearly resectable upfront. Margin-negative surgery is key, with radiotherapy as an alternative for unresectable tumors.
Area of Science:
- Oncology
- Surgical Oncology
- Medical Oncology
Background:
- Extraskeletal Ewing sarcoma (ESE) is a rare variant of Ewing sarcoma.
- This study evaluates prognostic factors and outcomes in ESE patients treated with multimodality therapy.
Purpose of the Study:
- To identify prognosticators for extraskeletal Ewing sarcoma.
- To assess outcomes of multimodality therapy for ESE.
Main Methods:
- Retrospective analysis of 47 ESE patients treated between 2013-2018.
- Standardized protocol with doxorubicin-based chemotherapy and local treatment.
- Follow-up to assess event-free survival (EFS) and overall survival (OS).
Main Results:
- Trunkal location, upfront surgery, and positive margins were associated with inferior EFS and OS.
- Multivariate analysis confirmed trunkal location and margin-positive resections as significant adverse prognostic factors for EFS.
- Three-year EFS was 41.1% and OS was 53%.
Conclusions:
- Downstage ESE with chemotherapy before local treatment if not clearly resectable upfront.
- Aim for margin-negative resection during surgery.
- Consider radiotherapy for tumors unsuitable for complete excision or when surgery poses high morbidity.
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