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Erschienen in: Pediatric Surgery International 12/2013

01.12.2013 | Original Article

Extraskeletal Ewing sarcoma in children and adolescents: impact of narrow but negative surgical margin

verfasst von: Sajid S. Qureshi, Siddharth Laskar, Seema Kembhavi, Sanjay Talole, Girish Chinnaswamy, Tushar Vora, Mukta Ramadwar, Saral Desai, Nehal Khanna, Mary Ann Muckaden, Purna Kurkure

Erschienen in: Pediatric Surgery International | Ausgabe 12/2013

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Abstract

Purpose

The aim of the study was to determine the impact of negative but close resection margins on local recurrence in children with extraskeletal Ewing sarcoma (EES).

Method

We reviewed records of 32 patients with EES treated between March 2005 and March 2013. All patients except one underwent surgical excision either upfront or after induction chemotherapy. Patients with viable tumor and negative surgical margins, which were categorized as less than or greater than 1 cm, were selected. Local control and survival analysis were performed for patients in both the groups.

Results

The 5-year event-free and overall survival rates of entire cohort is 68 and 77 %, respectively. Surgical margins were negative in 23/26 (90.3 %) patients. There were no local recurrences in any of the patients with margins of less than 1 cm. Only one patient with a margin greater than 1 cm had a local recurrence along with distant metastases. A tumor-free margin of more than 1 cm did not affect overall or event-free survival (p = NS).

Conclusion

Optimal local control is feasible in children with EES regardless of the quantitative extent of negative margins. Achieving a three-dimensional tumor-free margin should be the goal of surgical resection.
Literatur
1.
Zurück zum Zitat Tefft M, Vawter GF, Mitus A (1969) Paravertebral round cell tumors in children. Radiology 92:1501–1509PubMed Tefft M, Vawter GF, Mitus A (1969) Paravertebral round cell tumors in children. Radiology 92:1501–1509PubMed
2.
Zurück zum Zitat Granowetter L, Womer R, Devidas M et al (2009) Dose-intensified compared with standard chemotherapy for nonmetastatic Ewing sarcoma family of tumors: a Children’s Oncology Group Study. J Clin Oncol 27:2536–2541PubMedCrossRef Granowetter L, Womer R, Devidas M et al (2009) Dose-intensified compared with standard chemotherapy for nonmetastatic Ewing sarcoma family of tumors: a Children’s Oncology Group Study. J Clin Oncol 27:2536–2541PubMedCrossRef
3.
Zurück zum Zitat Applebaum MA, Worch J, Matthay KK et al (2011) Clinical features and outcomes in patients with extraskeletal Ewing sarcoma. Cancer 117:3027–3032PubMedCrossRef Applebaum MA, Worch J, Matthay KK et al (2011) Clinical features and outcomes in patients with extraskeletal Ewing sarcoma. Cancer 117:3027–3032PubMedCrossRef
4.
Zurück zum Zitat Raney RB, Asmar L, Newton WA Jr et al (1997) Ewing’s sarcoma of soft tissues in childhood: a report from the Intergroup Rhabdomyosarcoma Study, 1972 to 1991. J Clin Oncol 15:574–582PubMed Raney RB, Asmar L, Newton WA Jr et al (1997) Ewing’s sarcoma of soft tissues in childhood: a report from the Intergroup Rhabdomyosarcoma Study, 1972 to 1991. J Clin Oncol 15:574–582PubMed
5.
Zurück zum Zitat Castex MP, Rubie H, Stevens MC et al (2007) Extraosseous localized Ewing tumors: improved outcome with anthracyclines—the French society of pediatric oncology and International society of pediatric oncology. J Clin Oncol 25:1176–1182PubMedCrossRef Castex MP, Rubie H, Stevens MC et al (2007) Extraosseous localized Ewing tumors: improved outcome with anthracyclines—the French society of pediatric oncology and International society of pediatric oncology. J Clin Oncol 25:1176–1182PubMedCrossRef
6.
Zurück zum Zitat El Weshi A, Allam A, Ajarim D (2010) Extraskeletal Ewing’s sarcoma family of tumours in adults: analysis of 57 patients from a single institution. Clin Oncol 22:374–381CrossRef El Weshi A, Allam A, Ajarim D (2010) Extraskeletal Ewing’s sarcoma family of tumours in adults: analysis of 57 patients from a single institution. Clin Oncol 22:374–381CrossRef
7.
Zurück zum Zitat Rud NP, Reiman HM, Pritchard DJ (1989) Extraosseous Ewing’s sarcoma. A study of 42 cases. Cancer 64:1548–1553PubMedCrossRef Rud NP, Reiman HM, Pritchard DJ (1989) Extraosseous Ewing’s sarcoma. A study of 42 cases. Cancer 64:1548–1553PubMedCrossRef
8.
Zurück zum Zitat Sienbenrock KA, Nascimento AG, Rock MG (1996) Comparison of soft tissue Ewing’s sarcoma and peripheral neuroectodermal tumor. Clin Orthop 329:288–299CrossRef Sienbenrock KA, Nascimento AG, Rock MG (1996) Comparison of soft tissue Ewing’s sarcoma and peripheral neuroectodermal tumor. Clin Orthop 329:288–299CrossRef
9.
10.
Zurück zum Zitat Tural D, Molinas Mandel N, Dervisoglu S et al (2012) Extraskeletal Ewing’s sarcoma family of tumors in adults: prognostic factors and clinical outcome. Jpn J Clin Oncol 42:420–426PubMedCrossRef Tural D, Molinas Mandel N, Dervisoglu S et al (2012) Extraskeletal Ewing’s sarcoma family of tumors in adults: prognostic factors and clinical outcome. Jpn J Clin Oncol 42:420–426PubMedCrossRef
11.
Zurück zum Zitat Qureshi SS, Kembhavi S, Vora T et al (2013) Prognostic factors in primary nonmetastatic Ewing sarcoma of the rib in children and young adults. J Pediatr Surg 48:764–770PubMedCrossRef Qureshi SS, Kembhavi S, Vora T et al (2013) Prognostic factors in primary nonmetastatic Ewing sarcoma of the rib in children and young adults. J Pediatr Surg 48:764–770PubMedCrossRef
12.
Zurück zum Zitat Picci P, Böhling T, Bacci G et al (1997) Chemotherapy-induced tumor necrosis as a prognostic factor in localized Ewing’s sarcoma of the extremities. J Clin Oncol 15:1553–1559PubMed Picci P, Böhling T, Bacci G et al (1997) Chemotherapy-induced tumor necrosis as a prognostic factor in localized Ewing’s sarcoma of the extremities. J Clin Oncol 15:1553–1559PubMed
13.
Zurück zum Zitat Enneking WF, Spanier SS, Goodman MA (2003) A system for the surgical staging of musculoskeletal sarcoma. 1980. Clin Orthop Relat Res 415:4–18PubMedCrossRef Enneking WF, Spanier SS, Goodman MA (2003) A system for the surgical staging of musculoskeletal sarcoma. 1980. Clin Orthop Relat Res 415:4–18PubMedCrossRef
14.
Zurück zum Zitat Kushner BH, Hajdu SI, Gulati SG et al (1991) Extracranial primitive neuroectodermal tumors. The Memorial Sloan-Kettering Cancer Center experience. Cancer 67:1825–1829PubMedCrossRef Kushner BH, Hajdu SI, Gulati SG et al (1991) Extracranial primitive neuroectodermal tumors. The Memorial Sloan-Kettering Cancer Center experience. Cancer 67:1825–1829PubMedCrossRef
15.
Zurück zum Zitat Kinsella TJ, Triche TJ, Dickman PS et al (1983) Extraskeletal Ewing’s sarcoma: results of combined modality treatment. J Clin Oncol 1:489–495PubMed Kinsella TJ, Triche TJ, Dickman PS et al (1983) Extraskeletal Ewing’s sarcoma: results of combined modality treatment. J Clin Oncol 1:489–495PubMed
16.
Zurück zum Zitat Schuck A, Ahrens S, Paulussen M et al (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 55:168–177PubMedCrossRef Schuck A, Ahrens S, Paulussen M et al (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 55:168–177PubMedCrossRef
17.
Zurück zum Zitat Orr WS, Denbo JW, Billups CA et al (2012) Analysis of prognostic factors in extraosseous Ewing sarcoma family of tumors: review of St. Jude Children’s Research Hospital experience. Ann Surg Oncol 19:3816–3822CrossRef Orr WS, Denbo JW, Billups CA et al (2012) Analysis of prognostic factors in extraosseous Ewing sarcoma family of tumors: review of St. Jude Children’s Research Hospital experience. Ann Surg Oncol 19:3816–3822CrossRef
Metadaten
Titel
Extraskeletal Ewing sarcoma in children and adolescents: impact of narrow but negative surgical margin
verfasst von
Sajid S. Qureshi
Siddharth Laskar
Seema Kembhavi
Sanjay Talole
Girish Chinnaswamy
Tushar Vora
Mukta Ramadwar
Saral Desai
Nehal Khanna
Mary Ann Muckaden
Purna Kurkure
Publikationsdatum
01.12.2013
Verlag
Springer Berlin Heidelberg
Erschienen in
Pediatric Surgery International / Ausgabe 12/2013
Print ISSN: 0179-0358
Elektronische ISSN: 1437-9813
DOI
https://doi.org/10.1007/s00383-013-3409-2

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