Abstract
The aim here was to elucidate the current survival condition of patients diagnosed with Ewing's sarcoma of the bones and joints and determine independent risk factors associated with the prognosis. Retrospective cohort study based on the Surveillance, Epidemiology and End Results (SEER) database in the United States. We identified 397 patients who were diagnosed with Ewing's sarcoma of the bones and joints between January 2004 and December 2013. The multivariate Cox proportional hazards model was used to determine factors associated with the risk of death by adjusting for various factors. The one, two and five-year disease-specific survival rates were 89.08%, 78.08% and 62.47%, respectively. The factors related to death were age (≥ 18 years versus < 18 years; hazard ratio, HR = 1.77; 95% confidence interval, CI: 1.38-2.31); tumor site (extremity versus spine and pelvis; HR = 2.03; 95% CI: 1.31-2.62); tumor size (> 10 cm versus ≤ 10 cm; HR = 1.78; 95% CI: 1.34-2.56); and type of treatment (surgery alone versus radiotherapy with surgery; HR = 0.51; 95% CI: 0.38-0.89; or radiotherapy alone versus radiotherapy with surgery; HR = 1.61; 95% CI: 1.10-2.39; or no treatment versus radiotherapy with surgery; HR = 1.86; 95% CI: 1.23, 2.58). Patients with Ewing's sarcoma showed poor survival in situations of age ≥ 18 years, tumor size > 10 cm, receiving radiotherapy alone and receiving no treatment. Patients undergoing surgery alone had better survival.
Highlights
Ewing’s sarcoma is a rare cancer that accounts for less than 10% of all malignancies existing in the human body
Age ≥ 18 years (HR = 1.77; 95% confidence interval (CI) = 1.33-2.01), tumor originating in the spine and pelvis (HR = 2.03; 95% CI = 1.31-2.62), tumor size > 10 cm (HR = 1.78; 95% CI = 1.24-2.35), radiotherapy alone (HR = 1.61; 95% CI = 1.10-2.39) and no treatment (HR = 1.86; 95% CI = 1.23-2.58) were associated with increased risk of mortality, while receiving surgery alone (HR = 0.51; 95% CI = 0.38-0.89) was an independent predictor for longer survival
The development of diagnostic methods based on molecular techniques has had a great effect, because typical chromosomal translocations are commonly detected in Ewing’s sarcoma tissue
Summary
Ewing’s sarcoma is a rare cancer that accounts for less than 10% of all malignancies existing in the human body It stems from primitive neuroepithelial cells, which are able to differentiate into various mesenchymal cells, and has a propensity to metastasize to distant sites at an early stage. This cancer typically occurs in adolescents and young adults, accompanied by a very poor prognosis. The aim here was to elucidate the current survival condition of patients diagnosed with Ewing’s sarcoma of the bones and joints and determine independent risk factors associated with the prognosis.
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