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Annals of Oncology Advance Access originally published online on November 12, 2007
Annals of Oncology 2008 19(4):814-820; doi:10.1093/annonc/mdm521
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© The Author 2007. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For Permissions, please email: journals.permissions@oxfordjournals.org

pediatric malignancies

Prognostic factors for local and distant control in Ewing sarcoma family of tumors

C. Rodríguez-Galindo1,*, F. Navid1, T. Liu2, C. A. Billups2, B. N. Rao4 and M. J. Krasin3

1 Department of Oncology, St Jude Children's Research Hospital, Memphis, TN, USA
2 Department of Biostatistics, St Jude Children's Research Hospital, Memphis, TN, USA
3 Department of Radiological Sciences, St Jude Children's Research Hospital, Memphis, TN, USA
4 Department of Surgery, St Jude Children's Research Hospital, Memphis, TN, USA

* Correspondence to: Dr C. Rodríguez-Galindo, Department of Oncology, St Jude Children's Research Hospital, 332 N. Lauderdale, Memphis, TN 38105, USA. Tel: +1-901-495-2203; Fax: +1-901-521-9005; E-mail: carlos.rodriguez-galindo{at}stjude.org

Background: Advances in the treatment of Ewing sarcoma family of tumors (ESFT) are the result of improvements in systemic and local therapies. The individual contributions of each treatment component cannot be analyzed separately; improvements in local and systemic control can influence each other.

Patients and methods: We reviewed the records of 220 patients treated on institutional protocols from 1979 to 2004. Factors predictive of local and distant recurrence were analyzed.

Results: The median age at diagnosis was 13.7 years. Ninety-five patients relapsed at a median of 1.6 years. The 5-year overall survival estimate was 63.5% ± 3.5%. The estimated 5-year cumulative incidence (CI) of local failure was 25.1% ± 3.0%. Local failure was associated with treatment era (P < 0.001), tumor size (P = 0.037) and type of local control (P = 0.021). Systemic treatment intensification improved local control. The estimated 5-year CI of distant recurrence was 22.5% ± 2.9%. Patients with localized disease (P < 0.001), smaller tumors (P = 0.018) and those who received surgery ± radiation for local control (P = 0.023) had lower CI of distant failure.

Conclusions: Successful treatment of ESFT requires optimal systemic and local therapy. Both treatment modalities are intertwined and the control of both local and distant disease is the result of the combined approach.

Key words: distant recurrence, Ewing sarcoma, local recurrence, pediatric cancer

Received for publication May 27, 2007. Revision received October 8, 2007. Accepted for publication October 9, 2007.


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