Abstract

Purpose: This study analyzed oncological and functional outcomes of treatment for Ewing’s sarcoma, as well as its significant risk factors through long-term follow up. Objective and Method: Between September 1990 and April 2009, 20 cases that were diagnosed and treated as Ewing’s sarcoma in Kosin University Gospel Hospital were entered onto the study. Mean follow-up period was 45.4 (12 - 108) months. There were 7 cases of male and 13 cases of female, and mean age was 19.9 (5 - 48) years old. Retrospective review was done about treatment outcomes, complications, and significant risk factors. Results: In terms of oncologic results, there were 9 cases of CDF (continuous disease free), 1 case of NED (no evidence of disease), 4 cases of AWD (alive with disease), 5 cases of DOD (dead of disease), and 1 case of DWOD (dead with other disease). Five-year overall survival rate of all the patients was 70.0% and event-free survival rate was 50.0%. The mean MSTS (Musculoskeletal Tumor Society) score was 15.9 (53%) points at last follow-up. Among prognostic factors of age at diagnosis, Enneking stage, size of tumor, site of primary lesion, and distant metastasis, 5-year survival rate of groups without metastasis were 90.9%, nevertheless 44.4% in other group with the metastasis showing statistical significance (p = 0.020). Postoperative complications were 3 cases of infection, each 2 cases of ankylosis and metal failure, and each 1 case of leg length discrepancy, periprosthetic fracture, and local recurrence. Conclusion: Five-year survival rate of this study was similar to that of multicenter studies in America and Europe. Among the prognostic factors, distant metastasis was proven to be most significant. Enneking stage, size of tumor and site of primary lesion are also important and could be statistically significant if with more cases.

Highlights

  • Ewing’s sarcoma, which was first described by James Ewing in 1921, is a rare bone tumor that accounts for less than 10% of whole primary malignant bone tumor

  • Among prognostic factors of age at diagnosis, Enneking stage, size of tumor, site of primary lesion, and distant metastasis, 5-year survival rate of groups without metastasis were 90.9%, 44.4% in other group with the metastasis showing statistical significance (p = 0.020)

  • We retrospectively studied 20 patients who were diagnosed as Ewing’s sarcoma and treated at our institution in last 20 years, analyzed and report their oncologic and functional results, complications, and prognostic factors

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Summary

Introduction

Ewing’s sarcoma, which was first described by James Ewing in 1921, is a rare bone tumor that accounts for less than 10% of whole primary malignant bone tumor. This tumor is known to be second most common malignant bone tumor in children and adolescents, next to osteosarcoma. We retrospectively studied 20 patients who were diagnosed as Ewing’s sarcoma and treated at our institution in last 20 years, analyzed and report their oncologic and functional results, complications, and prognostic factors

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