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Volume 2006, Article ID 83548, 8 pages
Clinical Study

Improving Outcomes After Relapse in Ewing's Sarcoma: Analysis of 114 Patients From a Single Institution

Department of Oncology, University College Hospital, 250 Euston Road, London NW1 2PG, UK

Received 16 August 2005; Revised 13 August 2006; Accepted 22 August 2006

Copyright © 2006 Anne M. McTiernan et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


The outcome for patients with relapsed Ewing's sarcoma is poor. A retrospective analysis was carried out to identify factors associated with improved survival. Between 1992 and 2002, 114 patients presented with relapsed or progressive disease. Median time to progression/relapse was 13 months (range, 2–128). Treatment at relapse included high dose treatment (HDT) in 29 patients, and surgery or definitive radiotherapy in 29. 2 and 5-year post relapse survival (PRS) was 23.5% and 15.2%, respectively. In multivariate analysis, the most significant factors associated with improved survival were disease confined locally or to the lungs (2-year PRS, 40% versus 6%; P<.001), relapse >18 months from diagnosis (2-year PRS, 53% versus 8%; P<.001), HDT at relapse (2-year PRS, 62% versus 11%; P<.001), and surgery and/or radiotherapy at relapse (2-year PRS, 51% versus 14%; P<.001). First treatment failure in Ewing's sarcoma is mostly fatal. Improved survival can be achieved in selective patients with aggressive treatment. These improvements are confined to those without bone or bone marrow metastases.