The role of surgical margins in treatment of Ewing's sarcoma family tumors: experience of a single institution with 512 patients treated with adjuvant and neoadjuvant chemotherapy

International Journal of Radiation Oncology, Biology, Physics
G BacciPiero Picci

Abstract

To evaluate the importance of surgical margins for local and systemic control of Ewing's sarcoma family tumors (ESFT). Between 1979 and 1999, 512 patients with ESFTs entered 4 different adjuvant and neoadjuvant studies performed at a single institution. Of these patients, 335 were treated with surgery alone (196) or surgery followed by radiotherapy at doses of 44.8 Gy (139). We compared their outcome with that of the 177 patients who were locally treated by radiotherapy at 60 Gy. Local control (88.8% vs. 80.2%, p < 0.009) and 5-year disease-free survival (63.8% vs. 47.6%, p < 0.0007) were significantly better in patients treated with surgery and, among them, in those with adequate surgical margins (96.6% vs. 71,7%, p < 0.0008, and 69.6% vs. 46.3%, p < 0.0002). Nonetheless, better results were observed only in extremity tumors. Surgery is better than radiotherapy in cases of extremity ESFT with achievable adequate surgical margins, and in cases of inadequate surgical margins, adjuvant reduced-dose radiotherapy is ineffective. Therefore, when inadequate margins are expected, patients are better treated with full-dose radiotherapy from the start.

References

May 1, 1978·International Journal of Radiation Oncology, Biology, Physics·M TefftM Nesbit
Nov 1, 1978·The Journal of Bone and Joint Surgery. British Volume·G BacciP A Pagani
Sep 1, 1992·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·O OberlinC Carrié
Sep 1, 1990·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·E O BurgertP Thomas
Oct 1, 1990·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M E NesbitJ M Kissane
Jan 1, 1987·Journal of Cancer Research and Clinical Oncology·V GöbelU Göbel
Apr 1, 1985·European Journal of Cancer & Clinical Oncology·O OberlinJ Lemerle
Sep 1, 1993·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·P PicciP Ruggieri
Oct 1, 1996·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·J F KutteschL E Kun
Jun 1, 1997·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·A W CraftD Pearson
Sep 25, 1998·International Journal of Radiation Oncology, Biology, Physics·S S DonaldsonJ J Shuster
Jan 7, 2000·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·G BacciP Picci
Feb 7, 2001·The Journal of Bone and Joint Surgery. British Volume·R J GrimerP Cool
Apr 29, 2000·European Journal of Cancer : Official Journal for European Organization for Research and Treatment of Cancer (EORTC) [and] European Association for Cancer Research (EACR)·I ElomaaT A Alvegård
May 16, 2000·Clinical Orthopaedics and Related Research·J J EckardtF R Eilber
Mar 17, 2001·Journal of Clinical Oncology : Official Journal of the American Society of Clinical Oncology·M PaulussenH Jürgens
Dec 31, 2002·International Journal of Radiation Oncology, Biology, Physics·Andreas SchuckHeribert Jürgens
Feb 15, 2003·The Journal of Bone and Joint Surgery. British Volume·G BacciE Barbieri
Jul 22, 2004·Pediatric Blood & Cancer·Matthew J KrasinThomas E Merchant

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Citations

May 2, 2008·Current Treatment Options in Oncology·Stefan S BielackMichael Paulussen
Jun 24, 2009·Current Treatment Options in Oncology·Wesley HsuJean-Paul Wolinsky
Nov 8, 2008·Medical Oncology·Selmin AtaerginMustafa Ozturk
Nov 26, 2009·Spine·Daniel M SciubbaZiya L Gokaslan
Apr 25, 2014·Current Treatment Options in Oncology·Ali K OzturkJean-Paul Wolinsky
Jul 18, 2014·Der Unfallchirurg·H R DürrP-U Tunn
Dec 2, 2014·Pediatric Clinics of North America·Josephine H HaDuongLeo Mascarenhas
May 16, 2013·Radiographics : a Review Publication of the Radiological Society of North America, Inc·Mark D MurpheyMark J Kransdorf
Aug 21, 2013·Expert Opinion on Emerging Drugs·Francoise RediniDominique Heymann
Feb 14, 2012·Surgical Pathology Clinics·Rajiv Rajani, C Parker Gibbs
Mar 19, 2011·Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia·Yong YanYicheng Lu
Apr 29, 2014·Neurological Research·Peter Paul VargaAron Lazary
Mar 25, 2016·Japanese Journal of Clinical Oncology·Satoshi TakenakaHideki Yoshikawa
Oct 16, 2012·Clinical Oncology : a Journal of the Royal College of Radiologists·N Thorp
May 31, 2014·The Journal of Bone and Joint Surgery. American Volume·Bivas BiswasSameer Bakhshi
Oct 19, 2017·Journal of Surgical Oncology·Chong ZhuR L Randall
Dec 22, 2017·São Paulo Medical Journal = Revista Paulista De Medicina·Zi-Hao WanLiao-Bin Chen
Jun 19, 2008·Pediatric Blood & Cancer·S LaskarM A Muckaden
Apr 27, 2010·Clinical Orthopaedics and Related Research·Raffi S AvedianTerrance D Peabody
Jul 18, 2019·Asia-Pacific Journal of Clinical Oncology·Dina El DemellawyJoseph de Nanassy
Nov 5, 2019·Frontiers in Oncology·Conglin YeBin Zhang
Feb 20, 2020·Skeletal Radiology·Michael McCollShivani Ahlawat
Feb 25, 2019·Clinical & Translational Oncology : Official Publication of the Federation of Spanish Oncology Societies and of the National Cancer Institute of Mexico·J Alvarez-SanNicolasC Lamas-Gomez
Apr 22, 2020·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Eitaro IshisakaHideki Ogiwara
Aug 25, 2020·SN Comprehensive Clinical Medicine·Jagandeep Singh VirkRajeshwar Singh
Oct 7, 2015·Journal of Medical Imaging and Radiation Oncology·Matthew S NingEric T Shinohara
Jan 26, 2021·Sarcoma·Corentin MalherbePierre-Louis Docquier
Apr 4, 2021·Cancers·Asle Charles HeslaPanagiotis Tsagkozis
May 1, 2021·Journal of Clinical Medicine·Stefan K ZöllnerUta Dirksen
May 22, 2020·International Journal of Radiation Oncology, Biology, Physics·Haruka UezonoJulie A Bradley
Jul 30, 2021·European Journal of Orthopaedic Surgery & Traumatology : Orthopédie Traumatologie·Francesco MuratoriDomenico Andrea Campanacci
Feb 1, 2008·International Journal of Radiation Oncology, Biology, Physics·Daniel J IndelicatoRobert B Marcus
Aug 25, 2012·Clinical Oncology : a Journal of the Royal College of Radiologists·T BöllingU Dirksen

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