A single institution experience of combined modality management of extra skeletal Ewings sarcoma

详细信息    查看全文

• 作者：Ramachandran Venkitaraman (1)
  Mathew K George (2)
  S Ganapathy Ramanan (3)
  TG Sagar (2)
  
• 刊名：World Journal of Surgical Oncology
• 出版年：2007
• 出版时间：December 2007
• 年：2007
• 卷：5
• 期：1
• 全文大小：504KB
• 参考文献：1. Baldini EH, Demetri GD, Fletcher CD, Foran J, Marcus KC, Singer S: Adults with Ewing's sarcoma/primitive neuroectodermal tumor: adverse effect of older age and primary extraosseous disease on outcome. / Ann Surg 1999,230(1):79鈥?6. CrossRef
  2. Christie DR, Bilous AM, Carr PJ: Diagnostic difficulties in extraosseous Ewing's sarcoma: a proposal for diagnostic criteria. / Australas Radiol 1997,41(1):22鈥?8. CrossRef
  3. Stuart-Harris R, Wills EJ, Philips J, Langlands AO, Fox RM, Tattersall MH: Extraskeletal Ewing's sarcoma: a clinical, morphological and ultrastructural analysis of five cases with a review of the literature. / Eur J Cancer Clin Oncol 1986,22(4):393鈥?00. CrossRef
  4. Meister P, Gokel JM: Extraskeletal Ewing's sarcoma. / Virchows Arch A Pathol Anat Histol 1978,378(2):173鈥?79. CrossRef
  5. Hashimoto H, Tsuneyoshi M, Daimaru Y, Enjoji M: Extraskeletal Ewing's sarcoma. A clinicopathologic and electron microscopic. Analysis of 8 cases. / Acta Pathol Jpn 1985,35(5):1087鈥?098.
  6. Ushigome S, Shimoda T, Nikaido T, Nakamori K, Miyazawa Y, Shishikura A, Takakuwa T, Ubayama Y, Spjut HJ: Primitive neuroectodermal tumors of bone and soft tissue. With reference to histologic differentiation in primary or metastatic foci. / Acta Pathol Jpn 1992,42(7):483鈥?93.
  7. Ahmad R, Mayol BR, Davis M, Rougraff BT: Extraskeletal Ewing's sarcoma. / Cancer 1999,85(3):725鈥?31. CrossRef
  8. Rud NP, Reiman HM, Pritchard DJ, Frassica FJ, Smithson WA: Extraosseous Ewing's sarcoma. A study of 42 cases. / Cancer 1989,64(7):1548鈥?553. CrossRef
  9. Covelli HD, Beekman JF, Kingry RL: Extraskeletal Ewing's sarcoma: prolonged survival with recurrence after operation. / South Med J 1980,73(9):1294鈥?295.
  10. Kinsella TJ, Triche TJ, Dickman PS, Costa J, Tepper JE, Glaubiger D: Extraskeletal Ewing's sarcoma: results of combined modality treatment. / J Clin Oncol 1983,1(8):489鈥?95.
  
• 作者单位：Ramachandran Venkitaraman (1)
  Mathew K George (2)
  S Ganapathy Ramanan (3)
  TG Sagar (2)
  
  1. Division of Clinical Oncology, Royal Marsden Hospital, Sutton, Surrey, SM2 5PT, UK
  2. Division of Medical Oncology, Royal Darwin Hopsital, Casuarina, Australia
  3. Division of Medical Oncology, Cancer Institute(WIA), Adyar, Chennai, 400036, India
  

文摘

Background Extraskeletal Ewings sarcoma are rare tumors for which there is no consensus on optimal management. Methods A retrospective review of the clinical features, treatment and outcome of patients with extraskeletal Ewings sarcoma who reported to a single institution between January 1992 - December 2003 is reported. Results A total of 19 patients with extraskeletal Ewings sarcoma were identified. Of these, 4 patients had metastatic disease at presentation and 15 patients with non-metastatic disease received combined modality treatment with primary combination chemotherapy followed by local treatment with radiotherapy or surgery. Disease free survival and overall survival for patients with non metastatic disease after combined modality treatment were 60% and 30% respectively. The significant predictors for prolonged disease free survival and overall survival were high haemoglobin(p = 0.002), low lactate dehydrogenase (p = 0.028), chemotherapy with Vincristine, Adriamycin, Cyclophosphamide, Ifosfamide and Etoposide regime (p = 0.008) and complete response to chemotherapy (p = 0.001). Conclusion Aggressive combination chemotherapy followed by complete surgery or radiotherapy to a dose of more than 50 Gy is essential to confer optimal outcome for patients with extraskeletal ewings sarcoma.