title: Surgical treatment of patients with disseminated Ewing sarcoma in our clinical experience.
abstract: BACKGROUND
  Survival in advanced Ewing's sarcoma is unsatisfactory even with combination treatment. This paper tries to evaluate the impact of surgical treatment on treatment results.
  
  
  METHODS
  We discuss a series of 24 patients aged 6.1-18.9 years with disseminated Ewing's sarcoma treated in the years 2000-2008. The patients had metastases to the lungs (13 patients), bone (6 patients), or multiple sites (5 patients). The follow-up period ranged from 8 months to 8.5 years. The patients were treated in accordance with the EE99 protocol. 19 out of the 24 patients underwent surgery. Patients with lung metastases underwent resection of both the primary focus (12 children) as well as the lung metastases (6 children) or radiotherapy. Patients with metastases located elsewhere underwent resection of the primary focus and lung metastases, while the remaining metastatic sites were irradiated (7 children). The 6 remaining children received chemotherapy and radiotherapy.
  
  
  RESULTS
  Ten of the 19 patients who were operated on are alive. All those patients that were not operated on have died. The length of survival in the whole group has ranged from 8 months to 8.5 years (mean 2.8 years). Mean overall survival among these patients that were operated on is 3.1 years, and among those who had lung metastases at baseline and underwent metastatectomy, the survival rate is 4.3 years. The average survival rate among the non-operated on patients is 1.6 years.
  
  
  CONCLUSIONS
  Surgery appears to prolong survival among patients with disseminated Ewing's sarcoma.
authors.affiliation: Department of Surgical Oncology for Children and Adolescents, Mother & Child Research Institute, Warsaw. anna.raciborska@hoga.pl
authors.forename: Anna
authors.initials: A
authors.lastname: Raciborska
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Bilska
authors.forename: Elżbieta
authors.initials: E
authors.lastname: Rogowska
authors.forename: Jan
authors.initials: J
authors.lastname: Godziński
authors.forename: Wojciech
authors.initials: W
authors.lastname: Wożniak
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000401:mortality / Q000473:pathology* / Q000601:surgery*; D002648:Child; D003131:Combined Modality Therapy; D018572:Disease-Free Survival; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D009362:Neoplasm Metastasis / Q000628:therapy; D011044:Poland; D012512:Sarcoma, Ewing / Q000401:mortality / Q000556:secondary* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult