Provider views on the management of Ewing sarcoma of the spine and pelvis

Provider views on the management of Ewing sarcoma of the spine and pelvis INTRODUCTIONEwing sarcoma is the second most common primary bone neoplasm in childhood and adolescence. Tumors located in the pelvis and spine account for approximately 25% and 8% of all primary sites, respectively. Studies have reported that multiple pre‐treatment and post‐treatment prognostic factors exist including age, gender, tumor size, primary site, metastatic status, and response to chemotherapy. Clinical outcomes among different risk groups vary significantly, with the 5‐year event‐free survival rate for localized non‐pelvic tumors reaching 60% while that of pelvic or sacral tumors remaining as low as 30‐50%.Treatment of Ewing sarcoma involves multi‐agent systemic chemotherapy as well as local therapy consisting of either surgery, radiation or both. Although there have been abundant randomized clinical trials comparing chemotherapy regimens, prospective studies have not assessed the impact of local control choices on clinical endpoints. Local control for Ewing sarcoma of the spine and pelvis is especially challenging as wide resection may not be feasible in some circumstances either due to the risk of iatrogenic neurologic compromise or due to reconstructive challenges inherent in large pelvic defects. Marginal or intra‐lesional resections have been associated with inferior outcomes and current recommendations advise against this approach for local control. While Ewing sarcoma is considered http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png Journal of Surgical Oncology Wiley

Provider views on the management of Ewing sarcoma of the spine and pelvis

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Publisher
Wiley Subscription Services, Inc., A Wiley Company
Copyright
© 2018 Wiley Periodicals, Inc.
ISSN
0022-4790
eISSN
1096-9098
D.O.I.
10.1002/jso.24860
Publisher site
See Article on Publisher Site

Abstract

INTRODUCTIONEwing sarcoma is the second most common primary bone neoplasm in childhood and adolescence. Tumors located in the pelvis and spine account for approximately 25% and 8% of all primary sites, respectively. Studies have reported that multiple pre‐treatment and post‐treatment prognostic factors exist including age, gender, tumor size, primary site, metastatic status, and response to chemotherapy. Clinical outcomes among different risk groups vary significantly, with the 5‐year event‐free survival rate for localized non‐pelvic tumors reaching 60% while that of pelvic or sacral tumors remaining as low as 30‐50%.Treatment of Ewing sarcoma involves multi‐agent systemic chemotherapy as well as local therapy consisting of either surgery, radiation or both. Although there have been abundant randomized clinical trials comparing chemotherapy regimens, prospective studies have not assessed the impact of local control choices on clinical endpoints. Local control for Ewing sarcoma of the spine and pelvis is especially challenging as wide resection may not be feasible in some circumstances either due to the risk of iatrogenic neurologic compromise or due to reconstructive challenges inherent in large pelvic defects. Marginal or intra‐lesional resections have been associated with inferior outcomes and current recommendations advise against this approach for local control. While Ewing sarcoma is considered

Journal

Journal of Surgical OncologyWiley

Published: Jan 1, 2018

Keywords: ; ; ; ;

References

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