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Erschienen in: Journal of Cancer Research and Clinical Oncology 4/2005

01.04.2005 | Original Paper

Ewing’s sarcoma and primitive neuroectodermal tumor of hand and forearm

Experience of the Cooperative Ewing’s Sarcoma Study Group

verfasst von: Wolfgang Daecke, Susanne Ahrens, Herbert Juergens, Abdul-Kader Martini, Volker Ewerbeck, Rainer Kotz, Winfried Winkelmann, Ludger Bernd

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 4/2005

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Abstract

Purpose: Because Ewing’s sarcoma (EWS) is extremely rare in the hand and forearm, only limited data are available for planning treatment or predicting prognosis.
Methods: Data of 33 patients with EWS of the forearm or hand who were enrolled in studies of the German Association for Paediatric Oncology/Haematology and the European Intergroup Cooperative Ewing’s Sarcoma Study Group were analyzed. Patients received neoadjuvant multi-agent chemotherapy according to the valid protocol. Local treatment consisted of surgery (n=7), radiotherapy (n=7), or a combination of both (n=19).
Results: The 5/10-year overall survival rate was 84.1% (95% CI: 71.2–96.9)/74.1% (95% CI: 56.8–91.5), and both 5/10-year event-free survival rate were 71.3% (95% CI: 55.4–87.1). Only one of seven patients with secondary metastases was in remission at the time of analysis. One patient with local recurrence and another with primary metastases died. Altogether, eight of 33 patients died of their disease. The event-free survival rate was 80.6% in patients with good response to chemotherapy and 33.3% in patients with poor response. Surgery in combination with radiotherapy achieved a higher survival rate compared with radiotherapy or surgery alone. One out of two patients with nonwide margins of resection died of disease.
Conclusions: The results demonstrate a remarkably high survival rate for patients with EWS of the hand and forearm.
Literatur
1.
Zurück zum Zitat Ahrens S, Hoffmann C, Jabar S, Jabar S, Braun-Munzinger G, Paulussen M, Dunst J, Rübe C, Winkelmann W, Heinecke A, Göbel U, Winkler K, Harms D, Treuner J, Jürgens H (1999) Evaluation of prognostic factors in a tumor volume-adapted treatment strategy for localized Ewing sarcoma of bone: the CESS 86 experience. Med Pediatr Oncol 32:186–195 Ahrens S, Hoffmann C, Jabar S, Jabar S, Braun-Munzinger G, Paulussen M, Dunst J, Rübe C, Winkelmann W, Heinecke A, Göbel U, Winkler K, Harms D, Treuner J, Jürgens H (1999) Evaluation of prognostic factors in a tumor volume-adapted treatment strategy for localized Ewing sarcoma of bone: the CESS 86 experience. Med Pediatr Oncol 32:186–195
2.
Zurück zum Zitat Amico S, Lucas PG, Chelius P, Ruelle M, Liehn J, Valeyre J (1987) Ewing’s sarcoma of the thumb: radiographic, angiographic, CT and bone scan findings. Clin Nucl Med 12:671–672 Amico S, Lucas PG, Chelius P, Ruelle M, Liehn J, Valeyre J (1987) Ewing’s sarcoma of the thumb: radiographic, angiographic, CT and bone scan findings. Clin Nucl Med 12:671–672
3.
Zurück zum Zitat Athanasian WA (1999) Bone and soft tissue tumors. In: Green DP (ed) Operative hand surgery, 4th edn. Edinburgh: Churchill Livingstone, New York, pp 2223–2252 Athanasian WA (1999) Bone and soft tissue tumors. In: Green DP (ed) Operative hand surgery, 4th edn. Edinburgh: Churchill Livingstone, New York, pp 2223–2252
4.
Zurück zum Zitat Bacci G, Picci P, Gitelis S, Borghi A, Campanacci M (1982) The treatment of localized Ewing’s sarcoma. Cancer 49:1561–1570PubMed Bacci G, Picci P, Gitelis S, Borghi A, Campanacci M (1982) The treatment of localized Ewing’s sarcoma. Cancer 49:1561–1570PubMed
5.
Zurück zum Zitat Baraga JJ, Amrami KK, Swee RG, Wold L, Krishnan Unni K (2001) Radiographic features of Ewing’s sarcoma of the bones of the hands and feet. Skeletal Radiol 30:121–126 Baraga JJ, Amrami KK, Swee RG, Wold L, Krishnan Unni K (2001) Radiographic features of Ewing’s sarcoma of the bones of the hands and feet. Skeletal Radiol 30:121–126
6.
Zurück zum Zitat Besser E, Roessner A, Burg E, Erlemann R, Timm C, Grundmann E (1987) Bone tumors of the hand. A review of 300 cases documented in the Westphalian Bone Tumor Register. Arch Orthop Trauma Surg 106:241–47PubMed Besser E, Roessner A, Burg E, Erlemann R, Timm C, Grundmann E (1987) Bone tumors of the hand. A review of 300 cases documented in the Westphalian Bone Tumor Register. Arch Orthop Trauma Surg 106:241–47PubMed
7.
Zurück zum Zitat Bielack S, Kempf-Bielack B, Delling G, Exner G, Flege S, Helmke K, Kotz R, Salzer-Kuntschik M, Werner M, Winkelmann W, Zoubek A, Jürgens H, Winkler K (2002) Prognostic factors in high-grade osteosarcoma of the extremities or trunk. An analysis of 1702 patients treated on Cooperative Osteosarcoma Study Group protocols. J Clin Oncol 20:776–90CrossRefPubMed Bielack S, Kempf-Bielack B, Delling G, Exner G, Flege S, Helmke K, Kotz R, Salzer-Kuntschik M, Werner M, Winkelmann W, Zoubek A, Jürgens H, Winkler K (2002) Prognostic factors in high-grade osteosarcoma of the extremities or trunk. An analysis of 1702 patients treated on Cooperative Osteosarcoma Study Group protocols. J Clin Oncol 20:776–90CrossRefPubMed
8.
Zurück zum Zitat Cotterill SJ, Ahrens S, Paulussen M, Jürgens H, Voute P, Gadner H, Craft A (2000) Prognostic factors in Ewing’s tumor of bone: analysis of 975 patients from the European Intergroup Cooperative Ewing’s Sarcoma Study Group. J Clin Oncol 18:3108–3114PubMed Cotterill SJ, Ahrens S, Paulussen M, Jürgens H, Voute P, Gadner H, Craft A (2000) Prognostic factors in Ewing’s tumor of bone: analysis of 975 patients from the European Intergroup Cooperative Ewing’s Sarcoma Study Group. J Clin Oncol 18:3108–3114PubMed
9.
Zurück zum Zitat Dick HM, Francis KC, Johnston AD (1971) Ewing’s sarcoma of the hand. J Bone Joint Surg 53A:345–348 Dick HM, Francis KC, Johnston AD (1971) Ewing’s sarcoma of the hand. J Bone Joint Surg 53A:345–348
10.
Zurück zum Zitat Dick HM, Angelides AC (1989) Malignant bone tumors of the hand. Hand Clin 5:373–381PubMed Dick HM, Angelides AC (1989) Malignant bone tumors of the hand. Hand Clin 5:373–381PubMed
11.
Zurück zum Zitat Dreyfuss UY, Auslander L, Bialik V, Fishman J (1980) Ewing’s sarcoma of the hand following recurrent trauma: a case report. Hand 12:300–303PubMed Dreyfuss UY, Auslander L, Bialik V, Fishman J (1980) Ewing’s sarcoma of the hand following recurrent trauma: a case report. Hand 12:300–303PubMed
12.
Zurück zum Zitat Dryer RF, Buckwalter JA, Flatt AE, Bonfiglio M (1979) Ewing’s sarcoma of the hand. J Hand Surg 4A:372–374 Dryer RF, Buckwalter JA, Flatt AE, Bonfiglio M (1979) Ewing’s sarcoma of the hand. J Hand Surg 4A:372–374
13.
Zurück zum Zitat Dunst J, Sauer R (1993) Therapie des Ewing-Sarkoms. Strahlenther Onkol 12:695–708 Dunst J, Sauer R (1993) Therapie des Ewing-Sarkoms. Strahlenther Onkol 12:695–708
14.
Zurück zum Zitat Enneking WF (1980) A system for the surgical staging of the musculoskeletal sarcoma. Clin Orthop 153:106–21 Enneking WF (1980) A system for the surgical staging of the musculoskeletal sarcoma. Clin Orthop 153:106–21
15.
Zurück zum Zitat Euler E, Wilhelm K, Permanetter W, Kreusser TH (1990) Ewing’s sarcoma of the hand: localization and treatment. J Hand Surg 15A:659–662 Euler E, Wilhelm K, Permanetter W, Kreusser TH (1990) Ewing’s sarcoma of the hand: localization and treatment. J Hand Surg 15A:659–662
16.
Zurück zum Zitat Frassica FJ, Amadio PC, Wold LE, Dobyns JH, Linscheid RL (1989) Primary malignant bone tumors of the hand. J Hand Surg Am 14:1022–1028 Frassica FJ, Amadio PC, Wold LE, Dobyns JH, Linscheid RL (1989) Primary malignant bone tumors of the hand. J Hand Surg Am 14:1022–1028
17.
Zurück zum Zitat Freyschmidt J, Ostertag H, Jundt G (1998) Knochentumoren, 2nd edn. Springer-Verlag, Berlin Heidelberg New York, pp 423–453 Freyschmidt J, Ostertag H, Jundt G (1998) Knochentumoren, 2nd edn. Springer-Verlag, Berlin Heidelberg New York, pp 423–453
18.
Zurück zum Zitat Göbel V, Jürgens H, Etspüler G, Kemperdick H, Jungblut RM, Stienen U, Gobel U (1987) Prognostic significance of tumor volume in localized Ewing sarcoma of bone in children and adolescents. J Cancer Res Clin Oncol 113:187–191PubMed Göbel V, Jürgens H, Etspüler G, Kemperdick H, Jungblut RM, Stienen U, Gobel U (1987) Prognostic significance of tumor volume in localized Ewing sarcoma of bone in children and adolescents. J Cancer Res Clin Oncol 113:187–191PubMed
19.
Zurück zum Zitat Hoeffel JC (1993) Ewing’s sarcoma of the hand (letter). AJR 160:1362 Hoeffel JC (1993) Ewing’s sarcoma of the hand (letter). AJR 160:1362
20.
Zurück zum Zitat Huvos AG (1991) Bone tumors, diagnosis, treatment and prognosis, 2nd edn. Saunders, Montreal , pp 85–155 Huvos AG (1991) Bone tumors, diagnosis, treatment and prognosis, 2nd edn. Saunders, Montreal , pp 85–155
21.
Zurück zum Zitat Jürgens H, Exner U, Gadner H, Harms D, Michaelis J, Sauer R, Treuner J, Voute T, Winkelmann W, Winkler K, Göbel U (1988) Multidisciplinary treatment of primary Ewing’s sarcoma of bone: a 6-year experience of a European cooperative trail. Cancer 61:23–32PubMed Jürgens H, Exner U, Gadner H, Harms D, Michaelis J, Sauer R, Treuner J, Voute T, Winkelmann W, Winkler K, Göbel U (1988) Multidisciplinary treatment of primary Ewing’s sarcoma of bone: a 6-year experience of a European cooperative trail. Cancer 61:23–32PubMed
22.
Zurück zum Zitat Kaplan EL, Meier P (1958) Nonparametric estimation form incomplete observations. J Am Stat Assoc 53:457–81 Kaplan EL, Meier P (1958) Nonparametric estimation form incomplete observations. J Am Stat Assoc 53:457–81
23.
Zurück zum Zitat Kedar A, Bialik V, Fishman J (1984) Ewing sarcoma of the hand: literature review and a case report of nonsurgical management. J Surg Oncol 25:25–27PubMed Kedar A, Bialik V, Fishman J (1984) Ewing sarcoma of the hand: literature review and a case report of nonsurgical management. J Surg Oncol 25:25–27PubMed
24.
Zurück zum Zitat Kozlowski K, Azouz EM, Campbell J, Marton D, Morris L, Padovani J, Sprague P, Beluffi G, Berzero G, Cherubino P (1988) Primary bone tumours of the hand. Pediatr Radiol 18:140–148 Kozlowski K, Azouz EM, Campbell J, Marton D, Morris L, Padovani J, Sprague P, Beluffi G, Berzero G, Cherubino P (1988) Primary bone tumours of the hand. Pediatr Radiol 18:140–148
25.
Zurück zum Zitat Lacey SH, Danish EH, Thompson GH, Joyce M (1987) Ewing sarcoma of the proximal phalanx of a finger. J Bone Joint Surg 69A:931–934 Lacey SH, Danish EH, Thompson GH, Joyce M (1987) Ewing sarcoma of the proximal phalanx of a finger. J Bone Joint Surg 69A:931–934
26.
Zurück zum Zitat Mantel M (1966) Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother 50:163–70PubMed Mantel M (1966) Evaluation of survival data and two new rank order statistics arising in its consideration. Cancer Chemother 50:163–70PubMed
27.
Zurück zum Zitat Nesbit M, Percz C, Tefft M (1981) Multimodal therapy for the management of primary nonmetastatic Ewing’s sarcoma of bone: an intergroup study. Natl Canc Inst Monogr 56:255–262 Nesbit M, Percz C, Tefft M (1981) Multimodal therapy for the management of primary nonmetastatic Ewing’s sarcoma of bone: an intergroup study. Natl Canc Inst Monogr 56:255–262
28.
Zurück zum Zitat Ozaki T, Hashizume H, Kawai A, Inoue H (1995) Ewing’s sarcoma of the hand: magnetic resonance images and treatment. J Hand Surg 20A:441–444 Ozaki T, Hashizume H, Kawai A, Inoue H (1995) Ewing’s sarcoma of the hand: magnetic resonance images and treatment. J Hand Surg 20A:441–444
29.
Zurück zum Zitat Pandey S (1972) Ewing’s sarcoma of the third metacarpal. Int Surg 57:984–985PubMed Pandey S (1972) Ewing’s sarcoma of the third metacarpal. Int Surg 57:984–985PubMed
30.
Zurück zum Zitat Reinus WR, Gilula LA, Shirley SK, Askin F, Siegal G (1985) Radiographic appearance of Ewing sarcoma of the hands and feet: report from the Intergroup Ewing Sarcoma Study. AJR 144:331–336 Reinus WR, Gilula LA, Shirley SK, Askin F, Siegal G (1985) Radiographic appearance of Ewing sarcoma of the hands and feet: report from the Intergroup Ewing Sarcoma Study. AJR 144:331–336
31.
Zurück zum Zitat Salzer-Kuntschik M, Brand G, Delling G (1983) Determination of the degree of morphological regression following chemotherapy in malignant bone tumors. Pathologie 4:135–141 Salzer-Kuntschik M, Brand G, Delling G (1983) Determination of the degree of morphological regression following chemotherapy in malignant bone tumors. Pathologie 4:135–141
32.
Zurück zum Zitat Schuck A, Ahrens S, Paulussen M, Kuhlen M, Konemann S, Rube C, Winkelmann W, Kotz R, Dunst R, Willich N, Jürgens H (2003) Local therapy in localized Ewing tumors: results of 1058 patients treated in the CESS 81, CESS 86, and EICESS 92 trials. Int J Radiat Oncol Biol Phys. 55:168–77 Schuck A, Ahrens S, Paulussen M, Kuhlen M, Konemann S, Rube C, Winkelmann W, Kotz R, Dunst R, Willich N, Jürgens H (2003) Local therapy in localized Ewing tumors: results of 1058 patients treated in the CESS 81, CESS 86, and EICESS 92 trials. Int J Radiat Oncol Biol Phys. 55:168–77
33.
Zurück zum Zitat Shirley S, Askin F, Gilula L, Vietti T, Siegal G, Reinus W, Kissane J, Nesbit M (1985) Ewing’s sarcoma in bones of the hands and feet: a clinicopathologic study and review of the literature. J Clin Oncol 3:686–697 Shirley S, Askin F, Gilula L, Vietti T, Siegal G, Reinus W, Kissane J, Nesbit M (1985) Ewing’s sarcoma in bones of the hands and feet: a clinicopathologic study and review of the literature. J Clin Oncol 3:686–697
34.
Zurück zum Zitat Strege DW, Hanel DP, Vogler C, Schajowicz F (1989) Ewing sarcoma in a phalanx of an infant’s finger. J Bone Joint Surg 71A:1262–1265 Strege DW, Hanel DP, Vogler C, Schajowicz F (1989) Ewing sarcoma in a phalanx of an infant’s finger. J Bone Joint Surg 71A:1262–1265
Metadaten
Titel
Ewing’s sarcoma and primitive neuroectodermal tumor of hand and forearm
Experience of the Cooperative Ewing’s Sarcoma Study Group
verfasst von
Wolfgang Daecke
Susanne Ahrens
Herbert Juergens
Abdul-Kader Martini
Volker Ewerbeck
Rainer Kotz
Winfried Winkelmann
Ludger Bernd
Publikationsdatum
01.04.2005
Verlag
Springer-Verlag
Erschienen in
Journal of Cancer Research and Clinical Oncology / Ausgabe 4/2005
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-004-0637-9

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