title: Internal hemipelvectomy in the management of pelvic Ewing sarcoma - are outcomes better than with radiation therapy?
abstract: BACKGROUND
  Pelvic Ewing sarcoma (ES) is commonly associated with a worse prognosis. Large size and location limit local control options to radiation therapy, and local recurrences are common. We evaluated the impact of hemipelvectomy and radiation on outcomes, including function.
  
  
  METHODS
  Thirty-nine patients (median age 13.5years) with ES of the pelvis and sacral bones were treated during the period 2000-2012. Fifteen were treated with definitive radiotherapy (RT), 9 patients underwent hemipelvectomy alone, and 15 were treated with combined hemipelvectomy and RT.
  
  
  RESULTS
  Twenty patients (51.2%) are alive with a median follow-up 3.2years from diagnosis. Median time from diagnosis to relapse was 1.3years. Three-year estimates of EFS and OS were 47% and 61%, respectively. Patients treated with surgery or surgery with RT had better outcome than patients treated with RT only (3-year OS 78% or 81% vs. 36%, respectively, p=0.00083). The outcome of patients with pelvic ES treated with hemipelvectomy was not significantly different from the outcome of all patients with Ewing sarcoma treated on the national Polish protocol.
  
  
  CONCLUSIONS
  Internal hemipelvectomy offers good chances of cure for patients with pelvic ES, with a reasonable rate of complications and good function.
authors.affiliation: Department of Surgical Oncology for Children and Youth, Institute of Mother and Child, Warsaw, Poland. Electronic address: anna.raciborska@hoga.pl.
authors.forename: Anna
authors.initials: A
authors.lastname: Raciborska
authors.affiliation: Department of Surgical Oncology for Children and Youth, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Bilska
authors.affiliation: Department of Surgical Oncology for Children and Youth, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Magdalena
authors.initials: M
authors.lastname: Rychlowska-Pruszynska
authors.affiliation: Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, Lublin, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Drabko
authors.affiliation: Department and Clinic of Pediatric Oncology, Hematology and Bone Marrow Transplantation, Wroclaw Medical University, Wroclaw, Poland.
authors.forename: Radosław
authors.initials: R
authors.lastname: Chaber
authors.affiliation: Department of Pediatric Hematology and Oncology Collegium Medicum, Nicolaus Copernicus University, Bydgoszcz, Poland.
authors.forename: Monika
authors.initials: M
authors.lastname: Pogorzała
authors.affiliation: Department of Pediatric Hematology and Oncology, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Katarzyna
authors.initials: K
authors.lastname: Połczyńska
authors.affiliation: Department of Paediatric Surgery Marciniak Hospital, Chair of Emergency Medicine, Medical University, Wroclaw, Poland.
authors.forename: Jan
authors.initials: J
authors.lastname: Godziński
authors.affiliation: Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, TX.
authors.forename: Carlos
authors.initials: C
authors.lastname: Rodriguez-Galindo
authors.affiliation: Department of Surgical Oncology for Children and Youth, Institute of Mother and Child, Warsaw, Poland.
authors.forename: Wojciech
authors.initials: W
authors.lastname: Wożniak
mesh_terms: D000293:Adolescent; D001859:Bone Neoplasms / Q000532:radiotherapy / Q000601:surgery*; D002648:Child; D002675:Child, Preschool; D003131:Combined Modality Therapy; D006428:Hemipelvectomy / Q000379:methods*; D006801:Humans; D009364:Neoplasm Recurrence, Local; D010384:Pelvic Bones / Q000601:surgery; D012447:Sacrum / Q000601:surgery; D012512:Sarcoma, Ewing / Q000532:radiotherapy / Q000601:surgery*; D016896:Treatment Outcome; D055815:Young Adult
keywords: Ewing sarcoma; Hemipelvectomy; Radiotherapy