Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca

Acta chirurgiae orthopaedicae et traumatologiae Cechoslovaca

Původní práce / Original papers

ACTA CHIRURGIAE ORTHOPAEDICAE ET TRAUMATOLOGIAE ČECHOSL.,
84, 2017, p. 431 - 435

Léčba Ewingova sarkomu soustředěná do jednoho centra ovlivňuje desetileté dlouhodobé přežití

Impact of Single Center Treatment on Ewing Sarcoma 10-Year Long Term Survival Rates

A. H. KRIEG1,2, S. GEHMERT2, R. ANGST1,3, J. R. RISCHEWSKI1,4, T. KÜHNE1,5, F. HEFTI1,2
1 Bone and Soft Tissue Tumour Center of the University of Basel (KWUB), Switzerland
2 Orthopaedic Department, University Children´s Hospital, Basel (UKBB), Switzerland
3 Paediatric Oncology Department Childrens Hospital, Aarau, Switzerland
4 Paediatric Oncology Department Childrens Hospital, Lucerne, Switzerland
5 Paediatric Oncology Department, University Children´s Hospital, Basel (UKBB), Switzerland

ABSTRACT

PURPOSE OF THE STUDY

Ewing sarcomas (ES) are the second most common solid malignant bone tumors in both, children and adolescents, and systemic chemotherapy protocols were established during the last 3 decades which proved to be a successful approach in addition to local treatment. The purpose of the present study is (i) to provide survival rates and prognostic factors for patients with ES which received treatment in a single center and (ii) to compare data with results of multicenter studies.

MATERIALS AND METHODS

Patients (n = 38) were treated by the same surgeon whereas surgery was combined with radiotherapy in 55.3% of the patients (n = 21). Median age at diagnosis was 17.5 years (4.7-60) and the median follow-up time for all patients was 8.2 years (9.8 years for survivors, 3.2 years for non-survivors).

RESULTS

The survival rate for metastasis free sarcoma decreases from 90.5% to 50% for patients diagnosed with disseminated disease stage. Patients with a good response to chemotherapy survived in 83.3% of the cases. In addition, a higher OS was found for patients younger than 15 years (82.4%) when compared to patients older than 15 years (73.3%). In contrast, multicenter studies reported lower survival rates for metastasis free (-60%) and metastasis stages (< 40%).

DISCUSSION

The survival rates in the present single center study are higher than the rates reported from multi-center studies although same chemotherapy protocols were used and no substantially difference are apparent for patient population.

CONCLUSIONS

Based on the present data we re-emphasize that patients with Ewing sarcoma receive appropriate treatment in a large and qualified center particularly considering the survival rates. In addition, our data underline that a close collaboration between the oncological team and the experienced surgeon is crucial for patient´s care.

Key words: Ewing sarcoma, survival rate, single center, prognostic factors, chemotherapy, surgery, multi center, single center

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