دورية أكاديمية
أعرض في EDS

Individual risk evaluation for local recurrence and distant metastasis in Ewing sarcoma: A multistate model: A multistate model for Ewing sarcoma.

التفاصيل البيبلوغرافية
العنوان: Individual risk evaluation for local recurrence and distant metastasis in Ewing sarcoma: A multistate model: A multistate model for Ewing sarcoma.
المؤلفون: Bosma SE; Department of Orthopedics, Leiden University Medical Center, Leiden, the Netherlands., Rueten-Budde AJ; Leiden University Mathematical Institute, Leiden, the Netherlands., Lancia C; Leiden University Mathematical Institute, Leiden, the Netherlands., Ranft A; University Hospital Essen, University Duisburg. Essen, Pediatrics III, Sarcoma Centre, West German Cancer Centre, German Cancer Consortium, Essen, Germany.; German Cancer Consortium (DKTK), Essen, Germany., Dirksen U; University Hospital Essen, University Duisburg. Essen, Pediatrics III, Sarcoma Centre, West German Cancer Centre, German Cancer Consortium, Essen, Germany.; German Cancer Consortium (DKTK), Essen, Germany., Krol AD; Department of Radiotherapy, Leiden University Medical Center, Leiden, the Netherlands., Gelderblom H; Department of Medical Oncology, Leiden University Medical Center, Leiden, the Netherlands., van de Sande MAJ; Department of Orthopedics, Leiden University Medical Center, Leiden, the Netherlands., Dijkstra PDS; Department of Orthopedics, Leiden University Medical Center, Leiden, the Netherlands., Fiocco M; Leiden University Mathematical Institute, Leiden, the Netherlands.; Medical Statistics/Biomedical Data Sciences, Leiden University Medical Center, Leiden, the Netherlands.
المصدر: Pediatric blood & cancer [Pediatr Blood Cancer] 2019 Nov; Vol. 66 (11), pp. e27943. Date of Electronic Publication: 2019 Aug 06.
نوع المنشور: Journal Article; Research Support, Non-U.S. Gov't
اللغة: English
بيانات الدورية: Publisher: John Wiley Country of Publication: United States NLM ID: 101186624 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1545-5017 (Electronic) Linking ISSN: 15455009 NLM ISO Abbreviation: Pediatr Blood Cancer Subsets: MEDLINE
أسماء مطبوعة: Original Publication: Hoboken, N.J. : John Wiley, c 2004-
مواضيع طبية MeSH: Models, Biological*, Bone Neoplasms/*pathology , Sarcoma, Ewing/*pathology, Adolescent ; Antineoplastic Combined Chemotherapy Protocols/therapeutic use ; Bone Neoplasms/secondary ; Bone Neoplasms/therapy ; Child ; Child, Preschool ; Combined Modality Therapy ; Disease Progression ; Female ; Follow-Up Studies ; Humans ; Infant ; Infant, Newborn ; Kaplan-Meier Estimate ; Male ; Margins of Excision ; Neoplasm Metastasis ; Neoplasm Recurrence, Local/epidemiology ; Neoplasm, Residual ; Proportional Hazards Models ; Retrospective Studies ; Risk Assessment ; Sarcoma, Ewing/secondary ; Sarcoma, Ewing/therapy
مستخلص: Background: We investigated the effects of surgical margins, histological response, and radiotherapy on local recurrence (LR), distant metastasis (DM), and survival in Ewing sarcoma.
Procedure: Disease evolution was retrospectively studied in 982 patients with Ewing sarcoma undergoing surgery after chemotherapy using a multistate model with initial state surgery, intermediate states LR, pulmonary metastasis (DMpulm), other DM ± LR (DMother), and final state death. Effect of risk factors was estimated using Cox proportional hazard models.
Results: The median follow-up was 7.6 years (95% CI, 7.2-8.0). Risk factors for LR are pelvic location, HR 2.04 (1.10-3.80), marginal/intralesional resection, HR 2.28 (1.25-4.16), and radiotherapy, HR 0.52 (0.28-0.95); for DMpulm the risk factors are <90% necrosis, HR 2.13 (1.13-4.00), and previous pulmonary metastasis, HR 4.90 (2.28-8.52); for DMother are 90% to 99% necrosis, HR 1.56 (1.09-2.23), <90% necrosis, HR 2.66 (1.87-3.79), previous bone/other metastasis, HR 3.08 (2.03-4.70); and risk factors for death without LR/DM are pulmonary metastasis, HR 8.08 (4.01-16.29), bone/other metastasis, HR 10.23 (4.90-21.36), and <90% necrosis, HR 6.35 (3.18-12.69). Early LR (0-24 months) negatively influences survival, HR 3.79 (1.34-10.76). Once DMpulm/DMother arise only previous bone/other metastasis remain prognostic for death, HR 1.74 (1.10-2.75).
Conclusion: Disease extent and histological response are risk factors for progression to DM or death. Tumor site and surgical margins are risk factors for LR. If disease progression occurs, previous risk factors lose their relevance. In case of isolated LR, time to recurrence is important for decision-making. Radiotherapy seems protective for LR especially in pelvic/axial. Low percentages of LR in extremity tumors and associated toxicity question the need for radiotherapy in extremity Ewing sarcoma.
(© 2019 The Authors. Pediatric Blood & Cancer Published byWiley Periodicals, Inc.)
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فهرسة مساهمة: Keywords: Ewing sarcoma; multistate model; personalized medicine; prediction; survival
تواريخ الأحداث: Date Created: 20190808 Date Completed: 20200225 Latest Revision: 20200225
رمز التحديث: 20240829
DOI: 10.1002/pbc.27943
PMID: 31389188
قاعدة البيانات: MEDLINE
الوصف
تدمد:1545-5017
DOI:10.1002/pbc.27943