Department of Orthopedic Surgery, Mayo Clinic, Rochester, Minnesota, USA.
Department of Radiation Oncology, Mayo Clinic, Scottsdale, Arizona, USA.
J Surg Oncol. 2023 Jul;128(1):105-110. doi: 10.1002/jso.27250. Epub 2023 Mar 31.
Extraskeletal Ewing sarcoma (EES), is a rare soft tissue sarcoma. Treatment for EES commonly involves chemotherapy and surgical resection (ST) or less commonly combined chemotherapy, surgery, and radiotherapy (ST + RT). The purpose of the current study was to evaluate our institutional experience treating EES.
We reviewed 36 (18 males:18 females) patients (mean age 30 years) with a nonretroperitoneal/visceral EES treated with either ST (n = 24, 67%) or ST + RT (n = 12, 33%). All patients were treated with chemotherapy, most commonly vincristine, doxorubicin, cyclophosphamide/ifosfamide and etoposide (VDC/IE, n = 23, 66%) Radiotherapy was mostly delivered preoperatively (n = 9). The mean follow-up was 8 years.
The 10-year disease specific survival for patients was 78%, with no difference in the survival between patients in the ST versus the ST + RT groups (83% vs. 71%, p = 0.86). There was no difference in the 10-year local recurrence (91% vs. 100%, p = 0.29) or metastatic free survival (87% vs. 75%, p = 0.45) between the ST and ST + RT groups.
The results of the current study highlight the ability to achieve excellent local control with chemotherapy and surgery for EES. We recommend for multidisciplinary management of patients with EES, including chemotherapy and surgery, with use of radiotherapy if there is concern for a potentially close margin of resection.
骨外尤文肉瘤(EES)是一种罕见的软组织肉瘤。EES 的治疗通常包括化疗和手术切除(ST),或较少见的联合化疗、手术和放疗(ST+RT)。本研究的目的是评估我们机构治疗 EES 的经验。
我们回顾了 36 名(18 名男性:18 名女性)非腹膜后/内脏 EES 患者(平均年龄 30 岁),分别接受 ST(n=24,67%)或 ST+RT(n=12,33%)治疗。所有患者均接受化疗,最常用的药物有长春新碱、多柔比星、环磷酰胺/异环磷酰胺和依托泊苷(VDC/IE,n=23,66%)。放疗大多在术前进行(n=9)。平均随访 8 年。
患者 10 年疾病特异性生存率为 78%,ST 组与 ST+RT 组患者的生存率无差异(83%比 71%,p=0.86)。ST 组和 ST+RT 组的 10 年局部复发率(91%比 100%,p=0.29)和无远处转移生存率(87%比 75%,p=0.45)无差异。
本研究结果强调了化疗和手术治疗 EES 可获得良好的局部控制。我们建议对 EES 患者进行多学科管理,包括化疗和手术,如有潜在的切除边缘接近,可考虑放疗。