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

McTiernan, Anne M.; Cassoni, Anna M.; Driver, Deirdre; Michelagnoli, Maria P.; Kilby, Anne M.; Whelan, Jeremy S.

doi:https://doi.org/10.1155/SRCM/2006/83548

Sarcoma

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Clinical Study | Open Access

Volume 2006 | Article ID 083548 | https://doi.org/10.1155/SRCM/2006/83548

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

Anne M. McTiernan,¹Anna M. Cassoni,¹Deirdre Driver,¹Maria P. Michelagnoli,¹Anne M. Kilby,¹and Jeremy S. Whelan¹

Received16 Aug 2005

Revised13 Aug 2006

Accepted22 Aug 2006

Published01 Nov 2006

Abstract

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.

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Copyright

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.

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