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Are we able to predict the outcome of Ewing sarcoma? Looking for clinical prognostic factors by a multidisciplinary approach

Coral Sánchez Pérez, Lydia Mediavilla Santos, Esther Carbó Laso, Diana María Crego Vita, José Antonio Calvo Haro, Francisco Javier Vaquero Martín.


Objective: Our main goal was to assess the outcome of patients with Ewing sarcoma (EWS) and identify prognostic factors.
Methods: A retrospective review of 65 patients diagnosed with EWS at our institution between 1991 and 2013.
Results: Patients had a median age of 19 years (0.3-76), and 63.1% were males. Median tumor size was 10 cm (2-30). Primary sites included the limbs (42.2%), pelvis (23.4%), and chest wall (9.4%). 22 patients (34.4%) had metastatic disease. Treatment: Surgical resection in 45 patients (76.3%) and external beam radiotherapy in 48 patients (75%). Chemotherapy regimens: VAIA/EVAIA in 15 patients (33%), VAC/IE in 15 patients (33%), and VIAE in 10 patients (22%). After a mean follow-up of 40.7 months (p25-75; 13.3- 86.16), 5-year actuarial overall survival (OS) and progression-free survival (PFS) were 67.34% and 49.2%, respectively. As determined by univariate analysis, OS was influenced by stage (p=0.0141) and chemotherapy (p= 0.036). Neither sex, age, LDH levels, primary tumor location, nor size, surgery, or radiation therapy were correlated to outcome. In the multivariate model, only stage remained significant (p

Key words: Ewing sarcoma family of tumors, sarcoma surgery, chemotherapy, Ewing diagnosis

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