Ewing’s Sarcoma (ES): A Single Centre Retrospective Study

Abstract

The treatment of Ewing’s sarcoma (ES), which is thought to be derived from primitive mesenchymal cells, involves chemotherapy, surgery and radiotherapy.  While there is ample data in the world literature showing drastic changes in outcome of this disease, prognosis in Indian patients is largely unknown due to dearth of studies in our setting. The objective of the present study was to study the clinical, pathologic, cytogenetic profile and outcome of Ewing’s sarcoma (ES) with combined modality of treatment. Fifty six patients who had pathologically proven diagnosis of Ewing’s sarcoma and had received treatment at our institute from 2003 to 2008 were included for retrospective analysis. These patients were treated as per first POG-CCG protocol and subjected to surgery, radiotherapy and chemotherapy and the outcome (event-free survival, local and systemic relapses, disease progression) was noted. These outcomes were correlated with site, volume of tumor, stage at presentation, patient age and cytogenetics. The results revealed that at a median follow-up of 36 months (range 6–86 months) the median event free survival was 24 months (m) while the 5-year event free survival rate was   36 ± 4.6%. High tumor volume, pelvic disease and metastasis at presentation had poor outcome. There was no correlation between age and cytogenetics with survival. Although the demographic profile in our study was similar to the world literature, the outcome of Ewing’s sarcoma in Indian patients was found to be inferior, with localised disease having an approximately fifty percent chance of being cured and a much worse outcome in  the setting of pelvic disease, high tumor burden and metastasis at presentation.