title: Prognostic factors and outcome in Askin-Rosai tumor: a review of 104 patients.
abstract: OBJECTIVE
  To evaluate the prognostic factors and treatment outcome of patients with Askin-Rosai tumor of the chest wall treated at a single institution.
  
  
  METHODS
  Treatment comprised multiagent chemotherapy and local therapy, which was either in the form of surgery alone, radical external-beam radiotherapy (EBRT) alone, or a combination of surgery and EBRT. Thirty-two patients (40%) were treated with all three modalities, 21 (27%) received chemotherapy and radical EBRT, and 19 (24%) underwent chemotherapy followed by surgery only.
  
  
  RESULTS
  One hundred four consecutive patients aged 3-60 years were treated at the Tata Memorial Hospital from January 1995 to October 2003. Most (70%) were male (male/female ratio, 2.3:1). Asymptomatic swelling (43%) was the most common presenting symptom, and 25% of patients presented with distant metastasis. After a median follow-up of 28 months, local control, disease-free survival, and overall survival rates were 67%, 36%, and 45%, respectively. Median time to relapse was 25 months, and the median survival was 76 months. Multivariate analysis revealed age ≥18 years, poor response to induction chemotherapy, and presence of pleural effusion as indicators of inferior survival. Fifty-six percent of patients with metastatic disease at presentation died within 1 month of diagnosis, with 6-month and 5-year actuarial survival of 14% and 4%, respectively.
  
  
  CONCLUSIONS
  Primary tumor size, pleural effusion, response to chemotherapy, and optimal radiotherapy were important prognostic factors influencing outcome. The combination of neoadjuvant chemotherapy, surgery, and radiotherapy resulted in optimal outcome.
authors.affiliation: Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India. laskars2000@yahoo.com
authors.forename: Siddhartha
authors.initials: S
authors.lastname: Laskar
authors.forename: Chandrika
authors.initials: C
authors.lastname: Nair
authors.forename: Suman
authors.initials: S
authors.lastname: Mallik
authors.forename: Gaurav
authors.initials: G
authors.lastname: Bahl
authors.forename: Suresh
authors.initials: S
authors.lastname: Pai
authors.forename: Tanuja
authors.initials: T
authors.lastname: Shet
authors.forename: Tejpal
authors.initials: T
authors.lastname: Gupta
authors.forename: Brijesh
authors.initials: B
authors.lastname: Arora
authors.forename: Ashish
authors.initials: A
authors.lastname: Bakshi
authors.forename: C S
authors.initials: CS
authors.lastname: Pramesh
authors.forename: Rajesh
authors.initials: R
authors.lastname: Mistry
authors.forename: Sajid
authors.initials: S
authors.lastname: Qureshi
authors.forename: Seema
authors.initials: S
authors.lastname: Medhi
authors.forename: Nirmala
authors.initials: N
authors.lastname: Jambhekar
authors.forename: Purna
authors.initials: P
authors.lastname: Kurkure
authors.forename: Shripad
authors.initials: S
authors.lastname: Banavali
authors.forename: Mary Ann
authors.initials: MA
authors.lastname: Muckaden
mesh_terms: D000293:Adolescent; D000328:Adult; D000971:Antineoplastic Combined Chemotherapy Protocols / Q000009:adverse effects / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D003037:Cobalt Radioisotopes / Q000627:therapeutic use; D003131:Combined Modality Therapy / Q000379:methods / Q000401:mortality; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015999:Multivariate Analysis; D018241:Neuroectodermal Tumors, Primitive, Peripheral / Q000401:mortality / Q000473:pathology / Q000556:secondary / Q000628:therapy*; D010996:Pleural Effusion / Q000401:mortality; D011379:Prognosis; D011879:Radiotherapy Dosage; D012074:Remission Induction; D015996:Survival Rate; D013899:Thoracic Neoplasms / Q000401:mortality / Q000473:pathology / Q000628:therapy*; D035441:Thoracic Wall; D047368:Tumor Burden; D055815:Young Adult
chemical_list: D003037:Cobalt Radioisotopes