Analysis of 41 cases of non-metastatic Ewing's sarcoma in children
10.7499/j.issn.1008-8830.2309077
- VernacularTitle:儿童非转移性尤文肉瘤41例分析
- Author:
Qing YUAN
1
;
Ya-Li HAN
;
Ci PAN
;
Jing-Yan TANG
;
Yi-Jin GAO
Author Information
1. 上海交通大学医学院附属上海儿童医学中心血液/肿瘤科,上海 200127
- Keywords:
Ewing's sarcoma;
Prognosis;
Risk Factor;
Child
- From:
Chinese Journal of Contemporary Pediatrics
2024;26(4):365-370
- CountryChina
- Language:Chinese
-
Abstract:
Objective To summarize the clinical characteristics,treatment outcomes,and prognostic factors of children with non-metastatic Ewing's sarcoma(ES).Methods A retrospective analysis was conducted on the clinical data of 41 children with non-metastatic ES diagnosed and treated at the Shanghai Children's Medical Center,Shanghai Jiao Tong University School of Medicine from January 2010 to December 2018.All patients underwent chemotherapy based on the RMS-2009 protocol of the center,and local treatment such as surgery and/or radiotherapy was performed according to risk grouping.The Kaplan-Meier method was used to calculate the overall survival(OS)and event-free survival(EFS)rates.Univariate prognostic analysis was performed using the log-rank test,and multivariate analysis was conducted with Cox regression.Results Of the 41 children,21 were male and 20 were female.The median age at diagnosis was 7.7 years(range:1.2-14.6 years).The median follow-up time for patients with event-free survival was 68.1 months(range:8.1-151.7 months).As of the last follow-up,33 patients were in complete remission,and the overall 5-year EFS and OS rates were(78±6)％and(82±6)％,respectively.Univariate analysis by the log-rank test showed that a tumor diameter ≥8 cm,time from diagnosis to start of local treatment ≥16 weeks,and incomplete surgical resection were associated with poor prognosis(P＜0.05).Multivariate Cox regression analysis indicated that incomplete surgical resection(HR=8.381,95％CI:1.681-41.801,P=0.010)was an independent risk factor for poor prognosis in children with ES.Secondary tumors occurred in 2 cases.Conclusions A comprehensive treatment strategy incorporating chemotherapy,surgery,and radiotherapy can improve the prognosis of children with ES.Poor prognosis is associated with an initial tumor diameter ≥8 cm,while complete surgical resection and early initiation of local treatment can improve outcomes.[Chinese Journal of Contemporary Pediatrics,2024,26(4):365-370]
