PELVIC EWING'S SARCOMA: OUR EXPERIENCE AND EVALUATION OF PROGNOSTIC FACTORS

Aim To determine the overall survival of patients with Pelvic Ewing9s Sarcoma treated in our unit and to identify prognostic factors in pelvic primaries that could be used to select patients who would most likely benefit from high intensity treatment. Method Between 1977 and 2009, 80 male and 66 female patients aged 2 to 60 (mean, 18) years with Pelvic Ewing9s Sarcomas were retrospectively reviewed from the Royal Orthopaedic Hospital Oncology Service Registry. Treatments included surgery, radiotherapy, chemotherapy, or any of them in combination. Event-free (from presentation to recurrence) and overall (from presentation to death/latest follow-up) survival rates were calculated using the Kaplan- Meier method. Influence of various factors (age at diagnosis, gender, tumour site, metastasis at presentation, surgery (and surgical margins), radiotherapy, and type of treatment on survival was assessed using SPSS 14.0 statistical software. Results Out of the 146 patients, 128 had available follow up and were eventually included in the analysis. Ninety two patients died (63%) within a mean follow-up of 51 months (range, 3-343). In multivariate analysis, metastases at diagnosis and development of metastases were associated with decreased survival. In terms of the type of treatment received, chemotherapy and surgery was found to be associated with increased survival rates compared to chemotherapy and radiotherapy (p=0.04). Factors that were statistically significant associated with the development of metastasis were location at the periacetabular region and development of local recurrence. In multivariate analysis, only the development of local recurrence was significantly associated with increased risk for metastasis development (p=0.003). No factor was found to associate significantly with the development of local recurrence. Conclusion Currently, the optimal management of Pelvic Ewing9s Sarcoma is controversial but our study shows increased survival rates with chemotherapy and surgery treatment.