Key result
Ewing sarcoma of the head and neck had better 10-year disease-specific survival than other locations, which lost significance on multivariate analysis.
Why the study?
Does Ewing sarcoma of the head and neck have different survival characteristics compared to Ewing sarcoma at other locations?
Cohort (n=3,360)
Yes
Does Ewing sarcoma of the head and neck have different survival characteristics compared to Ewing sarcoma at other locations?
Ewing sarcoma of the head and neck has a better prognosis than other locations, likely due to smaller tumor size and lower metastatic rate rather than being a distinct clinical entity.
Answers are grounded in this paper and cite their sources.
Apparent survival advantage for head-neck Ewing sarcoma is not independent; supports confounding by size and metastases rather than distinct biology.
OBJECTIVES: Ewing sarcoma is a rare tumor of the head and neck. Previous efforts to characterize Ewing sarcoma of the head and neck (ES-HN) have been limited to small retrospective series. The objective of this study was to analyze the demographic, clinicopathologic, treatment, and survival characteristics of ES-HN compared to Ewing sarcoma at other locations (ES-other). METHODS: Using the Surveillance, Epidemiology, and End Results (SEER) database, we compared 183 patients with ES-HN to 3177 patients with ES-other. Patient characteristics were analyzed with chi-square or t test. Ten-year disease-specific survival (DSS) and overall survival (OS) were estimated via the Kaplan-Meier method and compared using the log-rank test. Multivariate Cox regression analysis was used to determine if HN location was an independent prognosticator. RESULTS: The ES-HN displayed a lower tumor size ( P < .001) and metastatic rate ( P < .001) compared to ES-other. The ES-HN had a better 10-year DSS and OS than ES-other ( P = .001, P = .015, respectively). The HN location did not achieve statistical significance on multivariate Cox regression analysis ( P = .88). CONCLUSION: ES-HN does not appear to be a separate clinical entity compared to ES-other; rather, its associated improved prognosis is likely secondary to its smaller size and lower metastatic rate compared to ES-other.
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Ellis et al. (2017) conducted a cohort in Ewing sarcoma (n=3,360). Head and neck location (ES-HN) vs. Other locations (ES-other) was evaluated on 10-year disease-specific survival (DSS) and overall survival (OS) (p=0.001). Ewing sarcoma of the head and neck had better 10-year disease-specific survival than other locations, which lost significance on multivariate analysis.
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