Ewing sarcoma, analysis of survival at 6 years with multidisciplinary therapy

Abstract

Purpose: The purpose of this study is to present our series of Ewing sarcoma cases and the survival data obtained in the medium term, using a multidisciplinary therapy protocol.

Material, methods and results: Forty-one Ewing sarcomas were diagnosed, treated and followed-up in our hospital between 2004 and 2009 with an average age of 18.29 years. Seventy-eight percent were to Ewing sarcoma of the bone, the femur being the most frequent location. Sixty-eight percent had a localized stage at the time of diagnosis. At the end of follow-up, 40% of the patients did not survive, most died within the first 5 years of follow-up.

Discussion: In Spain, Ewing sarcoma is the most common primary malignant bone tumour in childhood, ahead of osteosarcoma. Its survival rate has increased greatly in the last 40 years, improvement attributable mainly to the aggressive use of chemotherapy and to multidisciplinary treatment, but its prognosis remains very poor, especially for those with metastasis at diagnosis, the main adverse prognostic factor. Because of its high mortality, many authors consider it a disseminated disease from the beginning, with non- detectable micrometastasis that condition final survival.

Conclusions: Early diagnosis and multidisciplinary therapy in referral centres are the best strategies currently available to us to provide these patients the maximum possibilities of cure of this disease.

Keywords: Childhood tumours; Ewing sarcoma; Malignant bone tumour; Sarcoma Ewing; Tumor óseo maligno; Tumores en infancia.