Hernias and Ewing's sarcoma family of tumours: a pooled analysis and meta-analysis.
BACKGROUND
Ewing's sarcoma family of tumours has been associated with a history of hernia and with a parental occupation of farming. However, the causes of these tumours remain unknown. We therefore aimed to investigate the association between hernia and Ewing's sarcoma family of tumours.


METHODS
We did a pooled analysis of two case-control studies and a meta-analysis of three case-control studies of Ewing's sarcoma family of tumours that had adequate information on history of hernia. The primary endpoint was development of a tumour from the Ewing's sarcoma family. 138 patients with such a tumour and 574 controls were included in the pooled analysis, and 357 patients with these tumours and 745 controls were included in the meta-analysis. Risk was assessed by an odds ratio (OR) and 95% CI by use of multivariate analysis with unconditional logistic regression for the pooled analysis and random effects model for the meta-analysis.


RESULTS
Pooled analysis showed that children with Ewing's sarcoma family of tumours were more likely to have had an umbilical hernia than were controls (odds ratio [OR] 3.3 [95% CI 1.3-8.0]). Meta-analysis showed that children with Ewing's sarcoma family of tumours were more likely to have had a hernia (3.2 [1.9-5.7]).


CONCLUSIONS
Ewing's sarcoma family of tumours and hernias (particularly inguinal hernias) have common embryological pathways of neuroectodermal origin, and environmental factors, such as farming, might link the two entities.
Valery
Patricia C
PC
Division of Population and Clinical Sciences, Queensland Institute of Medical Research, Royal Brisbane Hospital, Queensland 4029, Australia. Patricia.Valery@qimr.edu.au
Holly
Elizabeth A
EA
Sleigh
Adrian C
AC
Williams
Gail
G
Kreiger
Nancy
N
Bain
Chris
C
D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000150:complications*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D006547:Hernia / Q000150:complications* / Q000151:congenital; D006554:Hernia, Umbilical / Q000150:complications; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D016017:Odds Ratio; D012307:Risk Factors; D012512:Sarcoma, Ewing / Q000150:complications*