Acta chirurgiae orthopaedicae
et traumatologiae Čechoslovaca

Acta Chir Orthop Traumatol Cech. 2017; 84(6):431-435 | DOI: 10.55095/achot2017/066

Léčba Ewingova sarkomu soustředěná do jednoho centra ovlivňuje desetileté dlouhodobé přežitíPůvodní práce

A. H. KRIEG^1,2,*, S. GEHMERT², R. ANGST^1,3, J. R. RISCHEWSKI^1,4, T. KÜHNE^1,5, F. HEFTI^1,2

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

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.

Klíčová slova: Ewing sarcoma, survival rate, single center, prognostic factors, chemotherapy, surgery, multi center, single center

Zveřejněno: 1. prosinec 2017  Zobrazit citaci