Evaluating Prognostic Factors for Localized Ewing Sarcoma Family of Tumors

the Cancer Therapy Advisor take:

Systemic chemotherapy has improved the prognosis of Ewing sarcoma family of tumors (ESFT) over the last several decades. Although data on prognostic factors in localized ESFT exists, the majority of the published data lack accuracy due to several biasing factors.

The investigators aimed to determine the clinicopathological parameters in patients with ESFT receiving uniform chemotherapy and analyze the prognostic treatment outcomes.

The study involves a single institutional review of patients diagnosed with ESFT that were treated between June 2003 and November 2011.

There were 224 patients with non-metastatic disease that were treated with a uniform chemotherapy protocol and disease response was assessed. In the analysis, 99 patients underwent surgery of which 50 received adjuvant radiotherapy and 80 received radical radiotherapy for local control.

At the median follow-up of 40.2 months, the event-free-survival (EFS), overall survival (OS), and local-control-rate, were 36.8 ± 3.6%, 52.4 ± 4.3%, and 63 ± 4.3%, respectively.

Based on the multivariate analysis, the EFS was predicted inferior in patients with tumor diameter >8 cm (P = 0.03), symptom duration >4 months (P = 0.04), and WBC >11 × 109 /L (P = 0.003); OS was predicted inferior in patients with ESFT in the spine/abdomino-pelvic location (P = 0.009) and WBC >11 × 109 /L (P = 0.003); local-control-rate was predicted inferior in patients with tumor size >8 cm (P = 0.03) and radical radiotherapy as local treatment.

Data show that the presence of two and three unfavorable prognostic factors had a statistically significant hazard ratio for OS and EFS; however, investigators conclude that further evaluation needs to be conducted on the biological differences in patients with ESFT of the spine or abdomino-pelvic region with high WBC account.