System for early prediction of progression of Ewingʼs sarcoma in children

Introduction. The prognosis in patients with Ewingʼs sarcoma (ES) is determined by a combination of factors such as the size of the primary tumor, the location and extent of the process, as well as the clinical response to drug treatment. Taking into account all prognostic indicators and the possibility of their correct assessment are necessary to stratify the risk of progression before starting treatment and to select the optimal approach to therapy. We have developed a mathematical prognostic model that allows us to form risk groups before starting program therapy. Materials and methods. A retrospective cohort single-center study was conducted in children with ES, who received treatment from 2012 to 2023 of the Research Institute of Pediatric Oncology and Hematology named after Academician of the Russian Academy of Medical Sciences L.A. Durnov at N.N. Blokhin National Medical Research Center of Oncology, Ministry of Health of Russia. To determine significant independent prognostic factors, univariate and multivariate Cox regression analysis was used. Prognostic significance was assessed by constructing ROC curves. Results. The following previously unassessed independent risk factors for progression were identified: initially high lactate dehydrogenase levels, leukocytosis, hyperfibrinogenemia and treatment program. A mathematical prognostic model for calculating the individual risk of progression has been created. The sensitivity of the developed system was 87.7 %, specificity – 94.0 %, accuracy – 91.3 %, positive predictive value – 91.9%, negative – 90.9 %. Conclusions. The developed Individual Probability of Progression Index demonstrated high prognostic ability in children with ES.