The clinical prognostic factors and treatment outcomes of adult patients with Ewing sarcoma

• Published in: International journal of clinical oncology Vol. 25; no. 11; pp. 2006 - 2014
• Main Authors: Jagodzińska-Mucha, Paulina, Ługowska, Iwona, Świtaj, Tomasz, Koseła-Paterczyk, Hanna, Wągrodzki, Michał, Kozak, Katarzyna, Falkowski, Sławomir, Morysiński, Tadeusz, Goryń, Tomasz, Dawidowska, Anna, Rutkowski, Piotr
• Format: Journal Article
• Language: English
• Published: Singapore Springer Singapore 01-11-2020; Springer Nature B.V
• Subjects: Adolescent; Adult; Aged; Antineoplastic Agents - adverse effects; Antineoplastic Agents - therapeutic use; Biopsy; Bone Neoplasms - mortality; Bone Neoplasms - pathology; Bone Neoplasms - therapy; Cancer Research; Chemotherapy; Combined Modality Therapy; Disease-Free Survival; Ewing's sarcoma; Ewings sarcoma; Female; Humans; Male; Medical prognosis; Medicine; Medicine & Public Health; Metastases; Metastasis; Middle Aged; Neoadjuvant Therapy; Oncology; Original Article; Patients; Prognosis; Sarcoma, Ewing - mortality; Sarcoma, Ewing - pathology; Sarcoma, Ewing - therapy; Surgical Oncology; Survival; Survival Rate; Toxicity; Treatment Outcome; Young Adult; Ewing sarcoma; Treatment; Diagnosis; Prognostic factors
• ISSN: 1341-9625; 1437-7772
• DOI: 10.1007/s10147-020-01741-7

Background
The data about treatment results of Ewing sarcoma in adult patients are limited. The aim of our study was to analyze prognostic factors and outcomes of therapy in this group of patients.
Methods
Between 2000 and 2018, 180 patients at the age of > 18 years old diagnosed with Ewing sarcoma were treated in referral center according to multimodal protocols. In 50 patients (28%) treatment was initiated outside our hospital, and 23 of them had started recommended therapy after 3 months since the date of biopsy/unscheduled operation. We analyzed clinical prognostic factors and overall survival (OS).
Results
The median age was 28 years (18–67 years), primary tumor was localized axially in 114 patients (63%), metastases at presentation were detected in 51 pts (28%). 5-year OS rate was 65% for patients with localized disease, in metastatic disease it was 15%; the presence and the number of metastases was a prognostic factor. 5-year PFS was significantly better in patients treated at referral center (or when the patients were admitted to referral center within 3 months from the date of biopsy, which was performed outside referral center), comparing to patients treated initially outside referral center; 5-year PFS rates in total population were 28 and 13%, respectively. In terms of OS, unfavorable prognostic factor showing a statistical trend (
p
 = 0.098) was lower dose density of neoadjuvant chemotherapy due to toxicity.
Conclusions
Approximately two-third of adult patients with localized Ewing sarcoma survive 5 years. In order to improve survival of this patients the multidisciplinary treatment in referral center is mandatory.