Results of surgical resection in pelvic Ewing's sarcoma

OBJECTIVE: To evaluate the results of patients with non-metastatic Ewing's sarcoma of the pelvis treated with surgical resection as part of their multimodality treatment METHODS: Twenty-six patients treated between September 2000 and September 2009 were evaluated. Thirteen resections included the acetabulum and 13 did not. Thirteen resections excluding the acetabulum had no reconstruction. Arthrodesis was done in two, extracorporeal radiation and reimplantation in two, and pseudarthrosis in nine patients. RESULTS: Three patients had involved margins. Seventeen patients had good response to chemotherapy and nine were poor responders. Twenty-one patients were available for follow-up. The follow-up ranged from 4 to 129 months (mean 36 months). Thirteen patients are currently alive. There was one local recurrence. On Kaplan-Meier analysis the overall survival was 72% at 5 years. The 3-year survival in good responders to chemotherapy was 94% compared to 30% in poor responders. The Musculoskeletal Tumor Society Score ranged from 23 to 29, with patients in whom the acetabulum was retained having better function compared to patients in whom acetabulum was resected. CONCLUSION: Surgery provides good local control and oncologic outcomes with acceptable function in these patients.