Clinical features, prognostic factors and outcome in a series of 29 extra-skeletal Ewing Sarcoma. Adequate margins and surgery-radiotherapy association improve overall survival

Francesco Muratori; Nicola Mondanelli; Lorenzo Pelagatti; Filippo Frenos; Davide Matera; Giovanni Beltrami; Matteo Innocenti; Rodolfo Capanna; Giuliana Roselli; Guido Scoccianti; Lorenzo Livi; Daniela Greto; Cristina Muntoni; Giacomo Baldi; Angela Tamburini; Domenico Andrea Campanacci

doi:10.1016/j.jor.2020.03.018

Clinical features, prognostic factors and outcome in a series of 29 extra-skeletal Ewing Sarcoma. Adequate margins and surgery-radiotherapy association improve overall survival

J Orthop. 2020 Mar 25:21:236-239. doi: 10.1016/j.jor.2020.03.018. eCollection 2020 Sep-Oct.

Authors

Francesco Muratori¹, Nicola Mondanelli², Lorenzo Pelagatti¹, Filippo Frenos¹, Davide Matera¹, Giovanni Beltrami¹, Matteo Innocenti¹, Rodolfo Capanna³, Giuliana Roselli⁴, Guido Scoccianti¹, Lorenzo Livi⁵, Daniela Greto⁵, Cristina Muntoni⁵, Giacomo Baldi⁶, Angela Tamburini⁷, Domenico Andrea Campanacci¹

Affiliations

¹ Divisione di Ortopedia Oncologica e Ricostruttiva Azienda Ospedaliero Universitaria Careggi Firenze, Italy.
² Divisione Ortopedia e Traumatologia Azienda Ospedaliera Universitaria Siena, Italy.
³ Clinica Ortopedica Universitaria Pisa, Italy.
⁴ Istituto di Radiologia Azienda Ospedaliera Universitaria Careggi Firenze, Italy.
⁵ Istituto di Radioterapia, Azienda Ospedaliero Universitaria Careggi Firenze, Italy.
⁶ Divisione di Oncologia Medica, Ospedale Prato, Italy.
⁷ Divisione di Oncoematologia, Ospedale Meyer, Italy.

Abstract

Objective: Authors review a series of 29 extra-skeletal Ewing Sarcoma (EES).

Methods: They analyzed characteristics, prognostic factors and outcome of EES.

Results: Authors report 60% Overall Survival (OS) and 56% of Event Free Survival (EFS) at 5 years. Better 5 years EFS was found in patients with localized disease (68.8%) compared to metastatic EES (33.3%) (p = 0.042). Radiotherapy + surgery offered the best local treatment (p=0.017). Volume (p = 0.032), Surgical margins (p = 0.01), metastatic disease (p = 0.0013) were a significant prognostic factor for OS at 5-yrs.

Conclusion: Adequate margins and surgery+radiotherapy improve Overall Survival.

Keywords: Ewing sarcoma; Extra-skeletal; Margins; Metastasis; Surgery; Volume.