title: Primary non-metastatic Ewing sarcoma of the jaw in children: results of surgical resection and primary reconstruction.
abstract: OBJECTIVE
  The rarity of Ewing sarcoma (ES) of the jaw coupled with the technical challenge of resection and associated functional and cosmetic impairment has resulted in deficient data on surgical management of these tumors. The purpose of this study is to describe the results of surgical excision and reconstruction of primary non-metastatic ES of the mandible and maxilla in children.
  
  
  METHODS
  Consecutive patients (mandible = 6, maxilla = 5) treated with surgery from August 2005 to January 2013 were selected. All patients received induction chemotherapy and were selected for surgical resection based on the presence of specific criteria for operability.
  
  
  RESULTS
  The median age was 11.5 years (range 5-16 years). Free fibular osteocutaneous flap was commonly used for reconstruction. There were no complications related to microvascular anastomosis or flap loss. Five patients had 100% tumor necrosis and did not receive radiotherapy. Teeth alignment, chewing, swallowing, and speech were normal in all and donor site morbidity occurred in one. The 5-year overall, event-free survival, and local control are 87.5%, 72.9%, and 90%, respectively.
  
  
  CONCLUSIONS
  In eligible patients, surgery with contemporary reconstruction results in optimal oncological and functional outcome. Surgery also has the added advantage of identifying patients who may not need radiotherapy.
authors: Division of Pediatric Surgical Oncology, Department of Surgical Oncology, Tata Memorial Centre, Mumbai, India.
authors: Sajid S
authors: SS
authors: Qureshi
authors: Seema
authors: S
authors: Kembhavi
authors: Monica
authors: M
authors: Bhagat
authors: Siddharth
authors: S
authors: Laskar
authors: Girish
authors: G
authors: Chinnaswamy
authors: Tushar
authors: T
authors: Vora
authors: Maya
authors: M
authors: Prasad
authors: Mukta
authors: M
authors: Ramadwar
authors: Saral
authors: S
authors: Desai
authors: Nehal
authors: N
authors: Khanna
authors: Purna
authors: P
authors: Kurkure
authors: Sneha
authors: S
authors: Shah
authors: Vinay
authors: V
authors: Shankdhar
authors: Prabha
authors: P
authors: Yadav
mesh_terms: D000293:Adolescent; D017024:Chemotherapy, Adjuvant; D002648:Child; D002675:Child, Preschool; D018572:Disease-Free Survival; D004954:Esthetics; D005260:Female; D005360:Fibula / Q000637:transplantation; D006801:Humans; D008297:Male; D008339:Mandibular Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D063175:Mandibular Reconstruction; D008441:Maxillary Neoplasms / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D011183:Postoperative Complications; D011862:Radiography, Panoramic; D012189:Retrospective Studies; D012512:Sarcoma, Ewing / Q000188:drug therapy / Q000401:mortality / Q000473:pathology / Q000601:surgery*; D013524:Surgical Flaps
keywords: Ewing sarcoma; head and neck; mandible; maxilla; reconstruction; surgery