Nonmetastatic Ewing's sarcoma of bone: the role of surgical therapy

The role of the orthopedic oncologist in the management of patients with Ewing's sarcoma (ES) is increasingly demanding. The initial radiographic evaluation demands a minimum sophistication of a current generation computed tomography (CT) evaluation of the chest and primary lesion followed by appropriate biopsy and pathology support. After completion of induction chemotherapy, radiographic reevaluation and restaging are followed by either "tailored port" or standard radiation therapy techniques, or surgical resection, as indicated in selected patients. Improvement of the care of ES patients requires the cooperation of physicians, surgeons, technicians, and social workers with appropriate training and skill.