Prognostic factors in nonmetastatic Ewing's sarcoma of bone treated with adjuvant chemotherapy

Analysis of 359 patients at the Istituto Ortopedico Rizzoli

Gaetano Bacci, Stefano Ferrari, Franco Bertoni, Simonetta Rimondini, Alessandra Longhi, Patrizia Bacchini, Cristiana Forni, Marco Manfrini, Davide Donati, Piero Picci

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Abstract

Purpose: The identification of prognostic factors in patients with nonmetastatic Ewing's sarcoma could allow the use of risk-adapted therapeutic strategies of treatment. Patients and Methods: Data on 359 patients with nonmetastatic Ewing's sarcoma of bone treated at a single institution between January 1979 and April 1995 were retrospectively considered. The influence of clinical, hematologic, therapeutic, and histologic parameters on event-free survival was assessed. Results: By univariate analysis, the following features were found to be associated with a poor prognosis: male sex (P <.02), age older than 12 years (P <.006), fever (P <.0001), anemia (P <.0025), high serum lactate dehydrogenase (LDH) level (P <.0001), axial location (P <.04), radiation therapy only for local control (P <.009), type of chemotherapy regimen (P <.0001), and poor chemotherapy-induced necrosis (P <.001). After multivariate analysis, the adverse independent prognostic factors were male sex (P <.04), age older than 12 years (P <.001), fever (P <.0002), anemia (P <.02), high serum LDH level (P <.0003), axial location (P <.02), and type of chemotherapy regimen (P <.0003). When the multivariate analysis was restricted to surgically treated patients, the adverse independent prognostic factors were poor chemotherapy-induced necrosis (P <.0001), fever (P <.015), anemia (P <.02), and high serum LDH level (P <.025). Conclusion: The prognosis in cases of nonmetastatic Ewing's sarcoma is influenced by many different clinical and hematologic variables, all of which are to be considered when patients are being stratified according to the risk of relapse. In surgically treated patients, the most important prognostic factor is chemotherapy-induced necrosis.

Original languageEnglish
Pages (from-to)4-11
Number of pages8
JournalJournal of Clinical Oncology
Volume18
Issue number1
Publication statusPublished - Jan 2000

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Ewing's Sarcoma
Adjuvant Chemotherapy
Anemia
Bone and Bones
Drug Therapy
L-Lactate Dehydrogenase
Fever
Necrosis
Multivariate Analysis
Serum
Disease-Free Survival
Radiotherapy
Therapeutics
Recurrence

ASJC Scopus subject areas

  • Cancer Research
  • Oncology

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Prognostic factors in nonmetastatic Ewing's sarcoma of bone treated with adjuvant chemotherapy : Analysis of 359 patients at the Istituto Ortopedico Rizzoli. / Bacci, Gaetano; Ferrari, Stefano; Bertoni, Franco; Rimondini, Simonetta; Longhi, Alessandra; Bacchini, Patrizia; Forni, Cristiana; Manfrini, Marco; Donati, Davide; Picci, Piero.

In: Journal of Clinical Oncology, Vol. 18, No. 1, 01.2000, p. 4-11.

Research output: Contribution to journalArticle

Bacci, Gaetano ; Ferrari, Stefano ; Bertoni, Franco ; Rimondini, Simonetta ; Longhi, Alessandra ; Bacchini, Patrizia ; Forni, Cristiana ; Manfrini, Marco ; Donati, Davide ; Picci, Piero. / Prognostic factors in nonmetastatic Ewing's sarcoma of bone treated with adjuvant chemotherapy : Analysis of 359 patients at the Istituto Ortopedico Rizzoli. In: Journal of Clinical Oncology. 2000 ; Vol. 18, No. 1. pp. 4-11.
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abstract = "Purpose: The identification of prognostic factors in patients with nonmetastatic Ewing's sarcoma could allow the use of risk-adapted therapeutic strategies of treatment. Patients and Methods: Data on 359 patients with nonmetastatic Ewing's sarcoma of bone treated at a single institution between January 1979 and April 1995 were retrospectively considered. The influence of clinical, hematologic, therapeutic, and histologic parameters on event-free survival was assessed. Results: By univariate analysis, the following features were found to be associated with a poor prognosis: male sex (P <.02), age older than 12 years (P <.006), fever (P <.0001), anemia (P <.0025), high serum lactate dehydrogenase (LDH) level (P <.0001), axial location (P <.04), radiation therapy only for local control (P <.009), type of chemotherapy regimen (P <.0001), and poor chemotherapy-induced necrosis (P <.001). After multivariate analysis, the adverse independent prognostic factors were male sex (P <.04), age older than 12 years (P <.001), fever (P <.0002), anemia (P <.02), high serum LDH level (P <.0003), axial location (P <.02), and type of chemotherapy regimen (P <.0003). When the multivariate analysis was restricted to surgically treated patients, the adverse independent prognostic factors were poor chemotherapy-induced necrosis (P <.0001), fever (P <.015), anemia (P <.02), and high serum LDH level (P <.025). Conclusion: The prognosis in cases of nonmetastatic Ewing's sarcoma is influenced by many different clinical and hematologic variables, all of which are to be considered when patients are being stratified according to the risk of relapse. In surgically treated patients, the most important prognostic factor is chemotherapy-induced necrosis.",
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T1 - Prognostic factors in nonmetastatic Ewing's sarcoma of bone treated with adjuvant chemotherapy

T2 - Analysis of 359 patients at the Istituto Ortopedico Rizzoli

AU - Bacci, Gaetano

AU - Ferrari, Stefano

AU - Bertoni, Franco

AU - Rimondini, Simonetta

AU - Longhi, Alessandra

AU - Bacchini, Patrizia

AU - Forni, Cristiana

AU - Manfrini, Marco

AU - Donati, Davide

AU - Picci, Piero

PY - 2000/1

Y1 - 2000/1

N2 - Purpose: The identification of prognostic factors in patients with nonmetastatic Ewing's sarcoma could allow the use of risk-adapted therapeutic strategies of treatment. Patients and Methods: Data on 359 patients with nonmetastatic Ewing's sarcoma of bone treated at a single institution between January 1979 and April 1995 were retrospectively considered. The influence of clinical, hematologic, therapeutic, and histologic parameters on event-free survival was assessed. Results: By univariate analysis, the following features were found to be associated with a poor prognosis: male sex (P <.02), age older than 12 years (P <.006), fever (P <.0001), anemia (P <.0025), high serum lactate dehydrogenase (LDH) level (P <.0001), axial location (P <.04), radiation therapy only for local control (P <.009), type of chemotherapy regimen (P <.0001), and poor chemotherapy-induced necrosis (P <.001). After multivariate analysis, the adverse independent prognostic factors were male sex (P <.04), age older than 12 years (P <.001), fever (P <.0002), anemia (P <.02), high serum LDH level (P <.0003), axial location (P <.02), and type of chemotherapy regimen (P <.0003). When the multivariate analysis was restricted to surgically treated patients, the adverse independent prognostic factors were poor chemotherapy-induced necrosis (P <.0001), fever (P <.015), anemia (P <.02), and high serum LDH level (P <.025). Conclusion: The prognosis in cases of nonmetastatic Ewing's sarcoma is influenced by many different clinical and hematologic variables, all of which are to be considered when patients are being stratified according to the risk of relapse. In surgically treated patients, the most important prognostic factor is chemotherapy-induced necrosis.

AB - Purpose: The identification of prognostic factors in patients with nonmetastatic Ewing's sarcoma could allow the use of risk-adapted therapeutic strategies of treatment. Patients and Methods: Data on 359 patients with nonmetastatic Ewing's sarcoma of bone treated at a single institution between January 1979 and April 1995 were retrospectively considered. The influence of clinical, hematologic, therapeutic, and histologic parameters on event-free survival was assessed. Results: By univariate analysis, the following features were found to be associated with a poor prognosis: male sex (P <.02), age older than 12 years (P <.006), fever (P <.0001), anemia (P <.0025), high serum lactate dehydrogenase (LDH) level (P <.0001), axial location (P <.04), radiation therapy only for local control (P <.009), type of chemotherapy regimen (P <.0001), and poor chemotherapy-induced necrosis (P <.001). After multivariate analysis, the adverse independent prognostic factors were male sex (P <.04), age older than 12 years (P <.001), fever (P <.0002), anemia (P <.02), high serum LDH level (P <.0003), axial location (P <.02), and type of chemotherapy regimen (P <.0003). When the multivariate analysis was restricted to surgically treated patients, the adverse independent prognostic factors were poor chemotherapy-induced necrosis (P <.0001), fever (P <.015), anemia (P <.02), and high serum LDH level (P <.025). Conclusion: The prognosis in cases of nonmetastatic Ewing's sarcoma is influenced by many different clinical and hematologic variables, all of which are to be considered when patients are being stratified according to the risk of relapse. In surgically treated patients, the most important prognostic factor is chemotherapy-induced necrosis.

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