Analysis of prognostic factors in ewing sarcoma family of tumors
Open Access
- 29 June 2007
- Vol. 110 (2), 375-384
- https://doi.org/10.1002/cncr.22821
Abstract
BACKGROUND. Advances in systemic and local therapies have improved outcomes for patients with the Ewing sarcoma family of tumors (ESFT). As new treatments are developed, a critical review of data from past treatment eras is needed to identify clinically relevant risk groups. METHODS. The authors reviewed the records of 220 patients with ESFT who were treated on protocols at St. Jude Children's Research Hospital from 1979 to 2004. Two treatment eras were defined. Factors predictive of outcome were analyzed to identify distinct risk groups. RESULTS. The median age at diagnosis was 13.7 years (range, 1.1–25.2 years). Metastatic disease was associated with tumors measuring >8 cm (P = .002) and axial location (P = .014). The 5-year overall survival (OS) estimate (63.5% ± 3.5%) did not appear to differ by protocol. Tumor stage and size were found to be the only independent predictors of outcome. Treatment era and type of local control therapy were found to influence the outcome of patients with localized disease. Four risk groups were defined: favorable risk (age P < .001). The incidence of therapy-related leukemia was significantly higher during the second treatment era, when more intensified regimens were used (6.1% ± 2.7% vs 0% ± 0%; P = .005). CONCLUSIONS. Risk stratification schemes such as this should be used to prospectively evaluate novel risk-based therapies. Studies of biologic pathways may help to refine this model. Cancer 2007. © 2007 American Cancer Society.This publication has 33 references indexed in Scilit:
- Concomitant administration of vincristine, doxorubicin, cyclophosphamide, ifosfamide, and etoposide for high‐risk sarcomasCancer, 2006
- Treatment of Ewing sarcoma family of tumors: Current status and outlook for the futureMedical and Pediatric Oncology, 2003
- Pharmacokinetics of Ifosfamide Administered According to Three Different Schedules in Metastatic Soft Tissue and Bone SarcomasJournal of Chemotherapy, 1998
- Long-term results from the first UKCCSG Ewing's tumour study (ET-1)European Journal of Cancer, 1997
- Ifosfamide plus etoposide in newly diagnosed Ewing's sarcoma of bone.Journal of Clinical Oncology, 1992
- Multimodal therapy for the management of nonpelvic, localized Ewing's sarcoma of bone: intergroup study IESS-II.Journal of Clinical Oncology, 1990
- Long-term results in 144 localized Ewing's sarcoma patients treated with combined therapyCancer, 1989
- Therapy for localized Ewing's sarcoma of bone.Journal of Clinical Oncology, 1989
- A Class of $K$-Sample Tests for Comparing the Cumulative Incidence of a Competing RiskThe Annals of Statistics, 1988
- Multidisciplinary treatment of primary Ewing's sarcoma of bone.A 6-year experience of a European cooperative trialCancer, 1988