A long-term review of the treatment of patients with Ewing's sarcoma in one institution.
OBJECTIVE
The treatment of patients suffering from Ewing's sarcoma has changed over the last three decades. We report the analyses, significant prognostic factors, interdisciplinary approach and development of therapy in one institution in Austria.


METHODS
One hundred and forty-two patients treated for Ewing's sarcoma between 1949 and 1994 were reviewed. Median follow-up was 8.5 years. Fifty-six patients were treated between 1949 and 1980 (group 1), and 86 patients between 1981 and 1994 (group 2). Patients in group 1 were treated with polychemotherapy. Patients in group 2 were treated with a neoadjuvant CESS (Cooperative Ewing's Sarcoma Study) regimen. In group 1, 24 patients underwent biopsy only, 32 patients had a definitive operation, 48 patients received either radiation therapy only or additional radiation therapy compared with in group 2: 6, 80 and 44 cases, respectively.


RESULTS
Five-year overall survival (OS) increased from 27% to 57%. Significant prognostic factors for OS were pre-operative metastases (P=0.0001), tumour location (P=0.0048), type of chemotherapy (P=0.002) and response to chemotherapy (P=0.0004). Chemotherapy (P=0.037), tumour location (P=0.0017) and metastases at diagnosis (P=0.0025) were significant.


CONCLUSIONS
The most effective treatment of Ewing's sarcoma is chemotherapy.
Sluga
M
M
Department of Orthopaedics, University of Vienna, Vienna, Austria. maria.sluga@akh-wien.ac.at
Windhager
R
R
Lang
S
S
Heinzl
H
H
Krepler
P
P
Mittermayer
F
F
Dominkus
M
M
Zoubek
A
A
Kotz
R
R
D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000627:therapeutic use; D001317:Austria; D001707:Biopsy, Needle; D001859:Bone Neoplasms / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D019637:Orthopedic Procedures / Q000379:methods; D011336:Probability; D018714:Radiotherapy, Adjuvant / Q000379:methods; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000175:diagnosis / Q000401:mortality* / Q000628:therapy*; D012680:Sensitivity and Specificity; D016019:Survival Analysis; D013997:Time Factors; D016896:Treatment Outcome