Surgical experience in the management of Ewing's sarcoma of bone

Experience has shown that treatment of Ewing's sarcoma of bone by radiation therapy to the primary site was complicated by failure to achieve local control, by unacceptable morbidity in the involved extremity, or possibly by the late development of secondary malignant lesions. Both retrospective and prospective data revealed that time before relapse and survival time after surgical treatment of the primary site were at least as long as that after radiation treatment. New protocols are exploring the value of surgical resection of the primary tumor in certain selected situations. The precise role of surgery in the treatment of primary Ewing's sarcoma of bone is not known. Optimal treatment may require the use of irradiation, surgery, and multiple-drug chemotherapy in various combinations.