Sanchez-Saba Javier E, Abrego Mariano O, Albergo José I, Farfalli Germán L, Aponte-Tinao Luis A, Ayerza Miguel A, Cayol Federico, Streitenberger Patricia, Risk Marcelo R, Roitman Pablo D
Servicio de Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, Argentina.
Servicio de Ortopedia y Traumatología, Hospital Italiano de Buenos Aires, Argentina. E-mail:
Medicina (B Aires). 2020;80(1):23-30.
Ewing sarcoma of the bone is a rare, highly aggressive tumor that typically affects children and young adults. In Argentina, the lack of Ewing's sarcoma registries reflects in the absence of information regarding prevalence, treatment protocols and patient's outcome. The purpose of this study was to analyze, in a group of patients diagnosed with Ewing sarcoma of the bone, treated with chemotherapy and limb-conserving surgery, their overall survival rate, local recurrence rate, and oncological risk factors. A retrospective research was conducted between 1990 and 2017. Eighty-eight patients with Ewing sarcoma of the bone matched the inclusion criteria. Median age was 14.5 years and median follow-up was 8.8 years. Overall survival rate was 79.5%, 69% and 64% at 2, 5 and 10 years respectively. Negative prognostic factors, associated with less survival rate after univariate analysis, were: bad response to chemotherapy (tumoral necrosis 0-89%), age > 16 years-old, central tumor localization and local recurrence. Gender and tumor size were not significant prognostic factors. After multivariate analysis, response to chemotherapy remained statistical significant. Local recurrence-free survival rate at 2 and 5 years was 87%. Tumor response to chemotherapy (0-89%) was the only significant factor for local recurrence. We consider that limb-salvage surgery, with neoadjuvant and adjuvant chemotherapy, are the mainstays of treatment for Ewing's sarcoma, with an overall survival rate, at 5 years, of 69%. In this population, response to chemotherapy is the most relevant prognostic factor, being associated with both local recurrence and overall survival.
骨尤因肉瘤是一种罕见的、侵袭性很强的肿瘤，通常影响儿童和青年。在阿根廷，由于缺乏尤因肉瘤登记系统，导致缺乏有关发病率、治疗方案和患者预后的信息。本研究的目的是分析一组接受化疗和保肢手术治疗的骨尤因肉瘤患者的总生存率、局部复发率和肿瘤危险因素。我们在1990年至2017年期间进行了一项回顾性研究。88例骨尤因肉瘤患者符合纳入标准。中位年龄为14.5岁，中位随访时间为8.8年。2年、5年和10年的总生存率分别为79.5%、69%和64%。单因素分析显示，与较低生存率相关的不良预后因素包括：化疗反应差（肿瘤坏死率0-89%）、年龄>16岁、肿瘤位于中央以及局部复发。性别和肿瘤大小不是显著的预后因素。多因素分析后，化疗反应仍具有统计学意义。2年和5年的无局部复发生存率为87%。肿瘤对化疗的反应（0-89%）是局部复发的唯一重要因素。我们认为，新辅助和辅助化疗联合保肢手术是尤因肉瘤的主要治疗方法，5年总生存率为69%。在这一人群中，化疗反应是最相关预后因素，与局部复发和总生存均相关。
