Abstract

Objective: Aim of this work is to assess clinical features, outcome and prognosis of adult patients diagnosed with Ewing Sarcoma (ES). Patients, Methods and Results: The records of 53 adult patients treated with Euro-Ewing protocol at Kuwait cancer control center (KCCC) over a period of 5 years were reviewed. Mean age was 26.9 ± 1.25 years. Thirty percent of patients presented with metastatic disease, and 65% of tumors were centrally located and 50% were ≥ 8 cm. All patients received initially VIDE protocol. 13.5% achieved complete remission (CR), and 57.7% achieved partial response (PR). Approximately 1/3 of patients underwent surgery which was adequate in 76% of them, and all patients received local radiotherapy. Post local treatment 56% of patients received VAC and 44% received VAI protocol. Mean treatment duration was 11 months ± 0.54. Median follow-up duration was 38.39 (33.49 - 43.28) months At the end of follow up 20% of patients relapsed locally and 36% distally. Median PFS was 46.9 months (95% CI 41.42 - 52.39), Median OS was 55.43 ms (95% CI 30.71 - 75.74); survivals at 3 and 5 years were 88%, 46% respectively. Conclusion: In this series metastases at presentation and wide surgical margins were the most important prognostic factors. Multimodality therapy is necessary for this rare disease.

Highlights

  • Aim of this work is to assess clinical features, outcome and prognosis of adult patients diagnosed with Ewing Sarcoma (ES)

  • The records of 53 adult patients treated with Euro-Ewing protocol at Kuwait cancer control center (KCCC) over a period of 5 years were reviewed

  • Multimodality therapy is necessary for this rare disease

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Summary

Introduction

ES is one of the most common malignancies during childhood and adolescence. It is considered the second most common primary bone malignancy during this period, with frequency approximately 2.9 per million in the population younger than 20 years, mostly among age group between 15 and 17 [1]. Few studies have investigated adult outcomes, and regarding the existing studies, there are ongoing controversies regarding prognosis. Adults have worse outcomes while in others, outcomes are similar to those among children and adolescents [3] [4]. The importance of age on ES prognosis remains debatable, but in most trials older age has been associated with an inferior clinical outcome. The exact reason of the poor prognostic effect of age is not clearly understood till it may be due to the fact that most adult cases present with pelvic disease and other biological factories [5] [6]

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