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Local and distant control in non‐metastatic pelvic Ewing's sarcoma patients
Author(s) -
Donati Davide,
Yin Junqiang,
Di Bella Claudia,
Colangeli Marco,
Bacci Gaetano,
Ferrari Stefano,
Bertoni Franco,
Barbieri Enza,
Mercuri Mario
Publication year - 2007
Publication title -
journal of surgical oncology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.201
H-Index - 111
eISSN - 1096-9098
pISSN - 0022-4790
DOI - 10.1002/jso.20752
Subject(s) - medicine , radiation therapy , chemotherapy , surgery , sarcoma , complication , pelvic tumor , pathology
Background and objectives Due to possible complication and loss of function, surgery is not often indicated in pelvic Ewing's sarcoma (ES). The purpose of this study was to review our experience and evaluate the role of different local treatment in non‐metastatic pelvic ES patients. Methods One hundred twenty‐nine patients with pelvic ES were treated at our institution between 1975 and 1999. We excluded patients presenting metastases, patients who had died of other causes, or those with incomplete clinical documentation. Among the 73 eligible patients, 17 (23%) with progression of tumor growth during induction chemotherapy eventually died. The analysis was focused on the remaining 56 patients with good or stable clinical response to the chemotherapy. Results Patients treated with surgery, with or without radiation therapy, had a better local control (82.6% vs. 66.7%) and a significantly higher rate of 5‐year EFS (73.9% vs. 30.3%, P = 0.036) than those who were only treated with local radiation therapy. Conclusion Chemotherapy is the key factor in the treatment of pelvic ES. In our series, surgical treatment was associated with good prognosis for pelvic ES. The use of radiotherapy alone was less effective and should be only used in non‐operable patients. Radiotherapy after surgery as a rescue method might not act effectively, while preoperative radiotherapy was associated with good clinical response and should be recommended. J. Surg. Oncol. 2007;96:19–25. © 2007 Wiley‐Liss, Inc.