Abstract
BackgroundThe pelvis is one of the primary sites of Ewing sarcoma (ES) and is associated with poorer prognoses than the extremities. Due to the rarity of this disease and limited data available, the prognostic factors of pelvic ES remain controversial. Thus, this study aimed to identify independent prognostic factors, and develop a nomogram for predicting survival rates in patients with pelvic ES.MethodsUsing data provided by the Surveillance, Epidemiology, and End Results (SEER) database, variables including age, sex, race, tumor size, tumor stage, surgery, and radiotherapy were analyzed using the Kaplan–Meier method and Cox proportional hazards regression. Based on the results of multivariate analyses, a nomogram was built to predict the overall survival (OS) of patients with pelvic ES. The performance of the nomogram was evaluated by the concordance index (C-index).ResultsA total of 267 cases diagnosed between 2004 and 2016 were included in the study. Univariate and multivariate analyses showed that patients who were younger, white, had a localized tumor stage, or underwent surgery were associated with improved prognoses, while no significant differences were observed in OS based on sex, tumor size, or radiotherapy. A nomogram was developed and the C-index was 0.728, indicating adequate performance for survival prediction.ConclusionsAge, race, tumor stage, and surgery were identified as independent prognostic factors for the OS of pelvic ES. The nomogram developed in this study can individually predict 3- and 5-year OS in patients with pelvic ES.
Highlights
Ewing sarcoma (ES) is a rare malignancy that accounts for ~8% of all primary malignant bone tumors with a peak incidence in children and adolescents (Ranft et al, 2017)
Following assessments of the aforementioned inclusion and exclusion criteria, a total of 267 patients were included in the study (Fig. 1)
The 267 pelvic ES patients were located in California (112, 41.9%), Connecticut (15, 5.6%), Georgia (26, 9.7%), Hawaii (3, 1.1%), Iowa (8, 3.0%), Kentucky (12, 4.5%), Louisiana (10, 3.8%), Michigan (9, 3.4%), New Jersey (32, 12.0%), New Mexico (6, 2.2%), Utah (13, 4.9%), and Washington (21, 7.9%)
Summary
Ewing sarcoma (ES) is a rare malignancy that accounts for ~8% of all primary malignant bone tumors with a peak incidence in children and adolescents (Ranft et al, 2017). The pelvis is one of the primary sites of Ewing sarcoma (ES) and is associated with poorer prognoses than the extremities. This study aimed to identify independent prognostic factors, and develop a nomogram for predicting survival rates in patients with pelvic ES. Based on the results of multivariate analyses, a nomogram was built to predict the overall survival (OS) of patients with pelvic ES. Univariate and multivariate analyses showed that patients who were younger, white, had a localized tumor stage, or underwent surgery were associated with improved prognoses, while no significant differences were observed in OS based on sex, tumor size, or radiotherapy. Conclusions: Age, race, tumor stage, and surgery were identified as independent prognostic factors for the OS of pelvic ES. The nomogram developed in this study can individually predict 3- and 5-year OS in patients with pelvic ES
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