Easy-to-use clinical tool for survival estimation in Ewing sarcoma at diagnosis and after surgery

Cancer research · Ewing sarcoma

A retrospective study of 1314 Ewing sarcoma patients was performed.

Accurate survival estimations in Ewing sarcoma are necessary to develop risk- and response adaptive treatment strategies allowing for early decision-making. We aim to develop an easy-to-use survival estimation tool from diagnosis and surgery. A retrospective study of 1314 Ewing sarcoma patients was performed. Associations between prognostic variables at diagnosis/surgery and overall survival (OS), were investigated using Kaplan‑Meier and multivariate Cox models. Predictive accuracy was evaluated by cross‑validation and Harrell C‑statistics. Median follow‑up was 7.9 years. Independent prognostic factors at diagnosis were age, volume, primary tumor localization and disease extent. 5 risk categories (A‑E) were identified with 5‑year OS of 88%, 69%, 57%, 51% and 28% respectively. Harrell C‑statistic was 0.70. Independent prognostic factors from surgery were age, volume, disease extent and histological response. In categories A‑B, 5‑y OS increased to 92% and 79% respectively for 100% necrosis and decreased to 76% and 62% respectively for <100% necrosis. In categories C‑E, 5‑y OS increased to 65%, 65% and 52% respectively for ≥90% necrosis and decreased to 38%, 11% and 7% respectively for <90% necrosis. We present an easy‑to‑use survival estimation tool from diagnosis in Ewing sarcoma based on age, volume, primary tumor localization and disease extent. Histological response is a strong additional prognostic factor for OS.

This large cohort provides robust data for developing and validating prognostic models to guide risk‑adapted treatment strategies in Ewing sarcoma.

Evidence level: Állatkísérletes. Állatmodellben vizsgálták.

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