Prognostic Factors and Clinical Outcomes in Extraskeletal Ewing Sarcoma: A Cohort Study.

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Abstract

[Indexed for MEDLINE] 10. J Egypt Natl Canc Inst. 2024 Aug 19;36(1):25. doi: 10.1186/s43046-024-00232-4. Prognostic factors and outcome of relapsed/progressive pediatric Ewing sarcoma: single-center 10-year experience. Arafah O(1), Hegazy RR(2)(3), Ayadi ME(2)(3), Nasr AM(4)(5), Fawzy M(2)(3). Author information: (1)Department of Pediatric Oncology, National Cancer Institute, Cairo University, I Fom El Khaleeg Street, Kasr El Aini Avenue, Cairo, 11796, Egypt. Omar.sarafah@cu.edu.eg. (2)Department of Pediatric Oncology, National Cancer Institute, Cairo University, I Fom El Khaleeg Street, Kasr El Aini Avenue, Cairo, 11796, Egypt. (3)Department of Pediatric Oncology, Children's Cancer Hospital Egypt 57357, Cairo, 11617, Egypt. (4)Department of Radiation Oncology, National Cancer Institute, Cairo University, Cairo, 11796, Egypt. (5)Department of Radiation Oncology, Children's Cancer Hospital Egypt 57357, Cairo, 11617, Egypt. BACKGROUND: Ewing sarcoma (ES) is the second most common primary malignant bone tumor in children and adolescents. Despite more intensive chemotherapy regimens and improved local control therapy, there is still a considerable rate of recurrent/progressive disease. METHODS: A retrospective study of 50 relapsed/progressive ES patients who were treated at the National Cancer Institute (NCI), Cairo University, during the period from 1st of January 2008 to the end of December 2018, to assess different prognostic variables and disease outcomes. RESULTS: Out of fifty eligible cases, 32 patients (64%) had disease recurrence, and 18 (36%) developed disease progression on treatment. The median follow-up period was 7.4 months. The median overall survival (OS) was 7.5 months, and the cumulative OS was 64% at 6 months and 32.6% at 1 year. The cumulative event-free survival (EFS) was 41.3% at 6 months and 22.3% at 1 year. Patients with disease recurrence had better OS and EFS than patients with disease progression (p = 0.019). Patients who underwent local control at relapse/progression had a significantly better outcome than patients who received chemotherapy only (p  2 years from initial diagnosis was the only independent predictor of better survival outcome. CONCLUSIONS: Patients with relapsing/progressive ES portended a poor outcome, with disease progression on treatment faring worse than relapse. Better outcome was observed in patients who experienced recurrence > 2 years after diagnosis, patients with disease recurrence rather than disease progression on treatment, and patients who underwent local control along with intensive chemotherapy. © 2024. The Author(s). DOI: 10.1186/s43046-024-00232-4 PMCID: PMC13313844