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

Abstract

Coral S

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<0.010). Conclusion: Although no significant results were found, EWS outcomes are known to depend on many clinical and treatment variables. Further studies should include variables that possibly have prognostic value.