Complications in long-term survivors of Ewing sarcoma.
BACKGROUND
Multimodality treatment has dramatically improved the outcome of patients with Ewing sarcoma. However, there appears to be little information concerning treatment-related complications in patients who are long-term survivors.


METHODS
Forty-one patients with Ewing sarcoma who were treated between 1960-1980 and who survived the disease by at least 20 years were included in the current study. In a retrospective analysis, all complications related to the multimodality treatment of Ewing sarcoma were assessed.


RESULTS
The patient group was comprised of 17 men and 24 women, with a mean age at the time of presentation of 16.8 years (range, 5-51 years). Approximately 20% of the lesions were located in the pelvis. All but 9 patients (78%) received chemotherapy as part of their treatment. The overall follow-up period averaged 25 years (range, 20-36 years). All except 1 patient were alive at the time of final follow-up, with the latter patient dying of radiation-induced secondary malignancy after 33 years. Only 17 patients (41%) were found to be free of any complication. These included metastases, local recurrence, secondary malignancies, pathologic fractures, and radiation-associated and chemotherapy-associated morbidities.


CONCLUSIONS
Although the patients in the current study were treated successfully in terms of surviving an aggressive tumor, the high complication rate in this group of long-term survivors is noteworthy and indicates that long-term follow-up should be mandatory.
Fuchs
Bruno
B
Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905, USA. fuchs.bruno@mayo.edu
Valenzuela
Richard G
RG
Inwards
Carrie
C
Sim
Franklin H
FH
Rock
Michael G
MG
D000293:Adolescent; D000328:Adult; D000359:Aftercare / Q000379:methods; D001859:Bone Neoplasms / Q000150:complications* / Q000401:mortality / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D012307:Risk Factors; D012512:Sarcoma, Ewing / Q000150:complications* / Q000401:mortality / Q000628:therapy; D015996:Survival Rate; D017741:Survivors; D016896:Treatment Outcome