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Recurrence of Ewing sarcoma: Is detection by imaging follow‐up protocol associated with survival advantage?
Author(s) -
Heinemann Melina,
Ranft Andreas,
Langer Thorsten,
Jürgens Herbert,
Kreyer Justus,
Vieth Volker,
Schäfers Michael,
Weckesser Matthias,
Simon Thorsten,
Hassenpflug Wolf,
Corbacioglu Selim,
Bielack Stefan,
MayerSteinacker Regina,
Kühne Thomas,
den Berg Henk,
Gelderblom Hans,
Bauer Sebastian,
Stegger Lars,
Dirksen Uta
Publication year - 2018
Publication title -
pediatric blood and cancer
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.116
H-Index - 105
eISSN - 1545-5017
pISSN - 1545-5009
DOI - 10.1002/pbc.27011
Subject(s) - medicine , sarcoma , hematology , population , retrospective cohort study , subgroup analysis , overall survival , oncology , confidence interval , pathology , environmental health
Background The Cooperative Ewing Sarcoma Study and the Late Effects Surveillance System of the Society for Paediatric Oncology and Haematology recommend a structured follow‐up imaging protocol (FUIP) for patients with Ewing sarcoma (EwS) with decreasing frequency of imaging over the first 5 years. The present study aims to assess the effectiveness of the FUIP for EwS patients regarding survival after relapse. Patients and methods A retrospective multicenter analysis on 160 eligible patients with EwS recurrence was performed. Potential survival differences following recurrence diagnosis between patients with protocol‐detected and symptomatic relapse were investigated using the Kaplan–Meier method. Additional subgroup analyses were performed on the relapse type. Overall survival (OS) was calculated from diagnosis of relapse to last follow‐up or death. Results In the multicenter analysis, recurrence was detected by FUIP in 77 of 160 patients (48%) and due to symptoms in 83 patients (52%). Regarding the entire study population, OS was significantly superior in patients with protocol‐detected relapse compared to patients with symptomatic relapse (median, 2.4 vs. 1.2 years; P < 0.001). In the subgroup analyses, patients whose lung recurrences were detected by the FUIP experienced longer survival after recurrence than those whose recurrences were detected symptomatically ( P = 0.023). In the 83 symptomatic patients, pain was the most prevalent symptom of relapse (72%). Conclusion FUIP may benefit survival in EwS relapse, especially in lung recurrence. Pain was the leading symptom of relapse.