title: Extraskeletal Ewing sarcoma in children and adolescents: impact of narrow but negative surgical margin.
abstract: OBJECTIVE
  The aim of the study was to determine the impact of negative but close resection margins on local recurrence in children with extraskeletal Ewing sarcoma (EES).
  
  
  METHODS
  We reviewed records of 32 patients with EES treated between March 2005 and March 2013. All patients except one underwent surgical excision either upfront or after induction chemotherapy. Patients with viable tumor and negative surgical margins, which were categorized as less than or greater than 1 cm, were selected. Local control and survival analysis were performed for patients in both the groups.
  
  
  RESULTS
  The 5-year event-free and overall survival rates of entire cohort is 68 and 77 %, respectively. Surgical margins were negative in 23/26 (90.3 %) patients. There were no local recurrences in any of the patients with margins of less than 1 cm. Only one patient with a margin greater than 1 cm had a local recurrence along with distant metastases. A tumor-free margin of more than 1 cm did not affect overall or event-free survival (p = NS).
  
  
  CONCLUSIONS
  Optimal local control is feasible in children with EES regardless of the quantitative extent of negative margins. Achieving a three-dimensional tumor-free margin should be the goal of surgical resection.
authors: Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Ernest Borges Road, Parel, 400012, Bombay, India, sajidshafiques@hotmail.com.
authors: Sajid S
authors: SS
authors: Qureshi
authors: Siddharth
authors: S
authors: Laskar
authors: Seema
authors: S
authors: Kembhavi
authors: Sanjay
authors: S
authors: Talole
authors: Girish
authors: G
authors: Chinnaswamy
authors: Tushar
authors: T
authors: Vora
authors: Mukta
authors: M
authors: Ramadwar
authors: Saral
authors: S
authors: Desai
authors: Nehal
authors: N
authors: Khanna
authors: Mary Ann
authors: MA
authors: Muckaden
authors: Purna
authors: P
authors: Kurkure
mesh_terms: D000293:Adolescent; D000328:Adult; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D018572:Disease-Free Survival; D005240:Feasibility Studies; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality; D012512:Sarcoma, Ewing / Q000401:mortality* / Q000601:surgery*; D015996:Survival Rate; D016896:Treatment Outcome; D055815:Young Adult
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