title: Complications in long-term survivors of Ewing sarcoma.
abstract: 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.
authors.affiliation: Department of Orthopedics, Mayo Clinic, Rochester, Minnesota 55905, USA. fuchs.bruno@mayo.edu
authors.forename: Bruno
authors.initials: B
authors.lastname: Fuchs
authors.forename: Richard G
authors.initials: RG
authors.lastname: Valenzuela
authors.forename: Carrie
authors.initials: C
authors.lastname: Inwards
authors.forename: Franklin H
authors.initials: FH
authors.lastname: Sim
authors.forename: Michael G
authors.initials: MG
authors.lastname: Rock
mesh_terms: 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