Key result
A prognostic model based on age, tumor volume, localization, and disease extent successfully stratified Ewing sarcoma patients into five risk categories for overall survival, with a C-statistic of 0.70.
Why the study?
Accurate survival estimations in Ewing sarcoma are needed to develop risk- and response-adaptive treatment strategies enabling early decision-making.
Observational (n=1,314)
Yes
An easy-to-use clinical tool based on age, tumor volume, localization, and disease extent accurately estimates survival in Ewing sarcoma at diagnosis, with histological response adding prognostic value after surgery.
Answers are grounded in this paper and cite their sources.
May support risk stratification in Ewing sarcoma; leaves open external validation before clinical use.
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 (95%CI 7.6-8.3). 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% (86-94), 69% (64-74), 57% (50-64), 51% (42-60) and 28% (22-34) respectively. Harrell C-statistic was 0.70. Independent prognostic factors from surgery were age, volume, disease extent and histological response. In categories A-B, 5y OS increased to 92% (87-97) and 79% (71-87) respectively for 100% necrosis and decreased to 76% (67-85) and 62% (55-69) respectively for <100% necrosis. In categories C-E, 5y OS increased to 65% (55-75), 65% (52-78) and 52% (38-66) respectively for ≥90% necrosis and decreased to 38% (22-54), 11% (0-26) and 7% (0-19) 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.
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Bosma et al. (2019) conducted an observational in Ewing sarcoma (n=1,314). Extrapulmonary metastasis (prognostic factor) vs. Localized disease was evaluated on Overall survival (HR 3.72, 95% CI 3.02-4.56, p=<0.001). A prognostic model based on age, tumor volume, localization, and disease extent successfully stratified Ewing sarcoma patients into five risk categories for overall survival, with a C-statistic of 0.70.
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