Provider views on the management of Ewing sarcoma of the spine and pelvis

Background Curative therapy for ES requires both chemotherapy and local control of primary tumor. There is no universally accepted standard approach to local control modalities. This survey was conducted to determine practice patterns and factors influencing the choice to offer various local control...

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Bibliographic Details
Published in:Journal of surgical oncology 2018-03, Vol.117 (3), p.417-424
Main Authors: Zhu, Chong, Olson, Kristofor A., Roth, Michael, Geller, David S., Gorlick, Richard G., Gill, Jonathan, Laack, Nadia N., Randall, RL
Format: Article
Language:English
Subjects:
Adolescent
Bone cancer
Bone Neoplasms - pathology
Bone Neoplasms - radiotherapy
Bone Neoplasms - surgery
Cancer surgery
Cross-Sectional Studies
Ewing sarcoma
Ewings sarcoma
Female
Humans
local control
Oncologists
Orthopedic Surgeons
Pelvic Bones - pathology
pelvis
practice pattern
Practice Patterns, Physicians
Radiation Oncology
Radiation therapy
Sarcoma, Ewing - pathology
Sarcoma, Ewing - radiotherapy
Sarcoma, Ewing - surgery
Spinal cancer
Spinal Neoplasms - pathology
Spinal Neoplasms - radiotherapy
Spinal Neoplasms - surgery
spine
Surgeons
Surgery
Surveys and Questionnaires
Thoracic Vertebrae - pathology
Tumors
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Summary:Background Curative therapy for ES requires both chemotherapy and local control of primary tumor. There is no universally accepted standard approach to local control modalities. This survey was conducted to determine practice patterns and factors influencing the choice to offer various local control modalities to patients with ES of the spine and pelvis. Methods The survey consisted of four scenarios involving a 15‐year‐old girl who presented with Ewing sarcoma of thoracic vertebra, sacrum, iliac wing, and acetabulum with or without neurologic compromise. The questionnaire was sent to oncologists, orthopedic surgeons, and radiation oncologists, asking their recommendations for local control modality. Results Among 94 respondents, radiotherapy was most frequently chosen for sacral tumors (68.1%) and T10 vertebral tumors (46.2%) whereas surgery was preferred for iliac wing pelvic tumors (45.7%) and acetabular tumors (43.6%). Orthopedic surgeons were significantly more likely to offer surgery than radiation oncologists (OR 3.07, 95%CI 1.37‐6.88, P = 0.007). Providers outside North America were more likely to offer combined surgery plus radiotherapy (OR 10.58, 95%CI 5.41‐20.70, P 
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.24860