Abstract
We evaluated the long-term results obtained in 402 patients with non-metastatic Ewing's
sarcoma (ES) of the bone treated in a single institution with adjuvant and neoadjuvant
chemotherapies between 1972 and 1992. Multivariate analyses showed male gender, age
older than 14 years, high serum lactate dehydrogenase (LDH) level, axial location
of the tumour, use of radiotherapy alone as a local treatment, and poor histological
response to chemotherapy, to be independent, adverse prognostic factors for event-free survival (EFS). At a mean follow-up of about 18 years (10–30 years),
177 patients (44.0%) remained continuously free of disease, 2 died of doxorubicin-induced
cardiotoxicity and 8 developed a second neoplasm (5 died, and 3 are alive and free
of disease). 215 patients relapsed with metastases and/or local recurrence: 14 are
alive and free of disease, 1 is alive with uncontrolled disease, and 200 died. The
overall survival (OS) at real follow-ups of 5-, 10-, 15- and 20-years was 57.2, 49.3,
44.9 and 38.4%, respectively. We conclude that since local or systemic relapses, treatment-complications
and second malignancies are more common after 5 years or more from the beginning of
treatment; a long-term follow-up is mandatory for patients with ES.
Keywords
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Article info
Publication history
Accepted:
August 29,
2003
Received in revised form:
July 8,
2003
Received:
January 30,
2003
Identification
Copyright
© 2003 Elsevier Science Ltd. Published by Elsevier Inc. All rights reserved.
