Impact of local treatment modality on overall‐ and disease‐specific survival for nonmetastatic pelvic and sacral Ewing sarcoma

Purpose The ideal local treatment modality for pelvic and sacral Ewing sarcoma (EWS) is controversial. Methods We present the data from the American College of Surgeon's National Cancer Database (NCDB) and the National Cancer Institute's Surveillance, Epidemiology and End Result (SEER) dat...

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Bibliographic Details
Published in:Journal of surgical oncology 2022-09, Vol.126 (3), p.577-587
Main Authors: Jawad, Muhammad Umar, Pollock, Brad H., Zeitlinger, Lauren N., O'Donnell, Edmond F., Traven, Sophia A., Carr‐Ascher, Janai R., Alvarez, Elysia, Malogolowkin, Marcio H., Thorpe, Steven W., Randall, R. Lor
Format: Article
Language:English
Subjects:
Cancer
Ewing sarcoma
Ewings sarcoma
pelvis
Radiation
radiotherapy
sacrum
Surgery
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Summary:Purpose The ideal local treatment modality for pelvic and sacral Ewing sarcoma (EWS) is controversial. Methods We present the data from the American College of Surgeon's National Cancer Database (NCDB) and the National Cancer Institute's Surveillance, Epidemiology and End Result (SEER) database to investigate the impact of local treatment modalities on survival for nonmetastatic pelvic and sacral Ewing sarcoma. Local treatment includes “surgery,” “radiation,” and a combination of “surgery and radiation.” Results A total of 235 cases from SEER and 285 cases from NCDB were analyzed. Patients with “localized” stage (intraosseous) in the SEER database did not show any statistically significant difference in the disease‐specific survival (DSS) for any of the local treatment modalities. Similar findings were observed for overall survival among patients with American Joint Committee on Cancer (AJCC) stage II and III in the NCDB database. However, patients with nonmetastatic disease, particularly regional disease (extraosseous), showed improved DSS with surgery only, in the SEER. Conclusion We found similar levels of efficacy for different treatment modalities for patients with intraosseous and AJCC II and III pelvic and sacral EWS. “Radiotherapy” is the most common local treatment modality employed in the United States. A prospective, randomized controlled trial with a direct head‐to‐head comparison is needed for a definitive conclusion.
ISSN:0022-4790
1096-9098
DOI:10.1002/jso.26922