title: Conditional Survival and Predictors of Late Death in Patients With Ewing Sarcoma.
abstract: OBJECTIVE
  Long-term survivors of Ewing sarcoma (EWS) are at considerable risk for future complications, including late relapse and death. Data on prognostic factors for late death in those who have survived beyond 5 years are lacking.
  
  
  METHODS
  We conducted a retrospective cohort study using the Surveillance, Epidemiology, and End Results database. We obtained clinical features and outcome data on 1,351 patients with EWS who had survived 60 months or more. From these data, we performed univariate and multivariable analyses of overall survival (OS) using log-rank tests and Cox proportional hazard models.
  
  
  RESULTS
  Of 1,351 patients in the cohort, there were 209 deaths, 144 (69%) of which were reported to be due to EWS. The OS for 5-year survivors at 10 years was 87.5% (95% confidence interval 85.4-89.3%). Univariate adverse prognostic factors for late death in 5-year survivors included age ≥ 18 years at initial diagnosis, male sex, and axial/pelvic primary site. Initial stage was not prognostic. Independent adverse prognostic factors for late death included black race (hazard ratio [HR] 2.16, P = 0.01), age ≥ 18 years at diagnosis (HR 2.02, P < 0.001), male sex (HR 1.43, P = 0.01), and axial/pelvic primary site (HR 1.43, P = 0.02).
  
  
  CONCLUSIONS
  The majority of late deaths in 5-year survivors are due to EWS. Black race, age ≥18 at diagnosis, male sex, and axial/pelvic primary site (but not stage at diagnosis) are independently associated with increased risk of late death.
authors.affiliation: Department of Pediatrics, UCSF Benioff Children's Hospital and University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Jillian R
authors.initials: JR
authors.lastname: Davenport
authors.affiliation: Department of Pediatrics, UCSF Benioff Children's Hospital and University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Kieuhoa T
authors.initials: KT
authors.lastname: Vo
authors.affiliation: Department of Pediatrics, UCSF Benioff Children's Hospital and University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Robert
authors.initials: R
authors.lastname: Goldsby
authors.affiliation: Department of Pediatrics, UCSF Benioff Children's Hospital and University of California, San Francisco School of Medicine, San Francisco, California.
authors.forename: Daniel C
authors.initials: DC
authors.lastname: West
authors.affiliation: Department of Pediatric Oncology, Dana-Farber/Boston Children's Cancer and Blood Disorders Center, Harvard Medical School, Boston, Massachusetts.
authors.forename: Steven G
authors.initials: SG
authors.lastname: DuBois
mesh_terms: D000293:Adolescent; D000328:Adult; D001859:Bone Neoplasms / Q000401:mortality*; D002648:Child; D015331:Cohort Studies; D005260:Female; D006801:Humans; D053208:Kaplan-Meier Estimate; D008297:Male; D009364:Neoplasm Recurrence, Local / Q000401:mortality*; D011379:Prognosis; D016016:Proportional Hazards Models; D012189:Retrospective Studies; D018426:SEER Program; D012512:Sarcoma, Ewing / Q000401:mortality*; D017741:Survivors; D055815:Young Adult
keywords: Ewing sarcoma; SEER; conditional survival; late death; prognostic factors