Surgical subtypes and survival in Ewing sarcoma: A National Cancer Database (NCDB) analysis.

Abstract

e23511 Background: Ewing sarcoma (EWS) is the one of the most common primary malignancies of bone, more commonly affecting the pediatric population Standard of care for EWS currently involves surgical intervention in combination with chemotherapy, in addition to the potential use of preoperative and/or postoperative radiation on a case by case basis. To date, there is not much in the literature reported regarding different surgical subtypes in these patients. Thus, this study aims to analyze survival outcomes amongst the different surgical subtypes in EWS patients. Methods: Using the NCDB, patients diagnosed with EWS between 2004-2018 were identified using ICD-O-3 histology code 9260. The cohort was analyzed to determine if they received any surgical intervention and, if so, which surgical subtype was used. Univariate analysis was then performed assessing patient length of survival for each surgical subtype. Data was analyzed using SPSS and statistical significance was set at α = 0.05. Results: A total of 2208 patients were included that had survival data and had received surgical intervention. The mean survival time of all patients was 118.1 months. Surgical patients survived an average of 137.2 months while nonsurgical patients survived 96.0 months on average (p < .00001). Analysis of surgical subtypes revealed significantly longer survival in patients who underwent radical excision with limb salvage compared to patients who underwent partial resection (p < .05). Patients who received a partial limb amputation survived significantly longer than patients who received a total limb amputation (p < .01). Patients who underwent local tumor excision or radial excision with limb salvage also survived significantly longer than patients with total limb amputation (p < .05 and p < .01, respectively). Conclusions: This study found that receipt of surgery is associated with longer survival in Ewing sarcoma patients. Further, different surgical interventions may influence survival in Ewing sarcoma as patients receiving radical excision with limb salvage fared better than partial resection and partial limb amputation better than total limb amputation. Future studies would benefit from investigating additional variables that may influence receipt of surgical interventions including patient demographics, socioeconomic status, and surgical center type.[Table: see text]