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Role of bone marrow biopsy for staging new patients with Ewing sarcoma: A systematic review
Author(s) -
Campbell Kevin M.,
Shulman David S.,
Grier Holcombe E.,
DuBois Steven G.
Publication year - 2021
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.28807
Subject(s) - medicine , sarcoma , bone marrow , biopsy , gold standard (test) , incidence (geometry) , positron emission tomography , ewing's sarcoma , radiology , predictive value , metastasis , pathology , cancer , physics , optics
The incidence of bone marrow metastasis (BMM) in newly diagnosed Ewing sarcoma (ES) is variable across studies. An optimal staging strategy for detecting BMM is not defined. While bone marrow (BM) biopsy and/or aspirate (BMBA) have been the gold standard, [F‐18]fluorodeoxyglucose positron emission tomography (FDG‐PET) to detect BMM may decrease reliance on BMBA. We conducted a systematic review to assess incidence of BMM and the role of FDG‐PET. We observed a pooled incidence of BMM by BMBA of 4.8% in all newly diagnosed ES patients and 17.5% among patients with metastatic disease. Only 1.2% of patients had BMM as their sole metastatic site. FDG‐PET detection of BMM compared to BMBA demonstrated pooled 100% sensitivity and 96% specificity, positive predictive value of 75%, and negative predictive value of 100%. In the era of FDG‐PET imaging, omission of BMBA may be considered in patients with otherwise localized disease after initial staging studies.