Impact of local treatment modality on overall- and disease-specific survival for nonmetastatic pelvic and sacral Ewing sarcoma
Muhammad Umar Jawad MD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorBrad H. Pollock PhD, MPH
Department of Public Health, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorLauren N. Zeitlinger DO
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorEdmond F. O'Donnell III MD, PhD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorSophia A. Traven MD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorJanai R. Carr-Ascher MD, PhD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Department of Medicine, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorElysia Alvarez MD, MPH
Department of Pediatrics, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorMarcio H. Malogolowkin MD
Department of Pediatrics, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorSteven W. Thorpe MD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorCorresponding Author
R. Lor Randall MD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Correspondence R. Lor Randall, Department of Orthopaedic Surgery, University of California-Davis, 4860 Y St, Suite 3800, Sacramento, CA 95817, USA.
Email: [email protected]
Search for more papers by this authorMuhammad Umar Jawad MD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorBrad H. Pollock PhD, MPH
Department of Public Health, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorLauren N. Zeitlinger DO
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorEdmond F. O'Donnell III MD, PhD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorSophia A. Traven MD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorJanai R. Carr-Ascher MD, PhD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Department of Medicine, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorElysia Alvarez MD, MPH
Department of Pediatrics, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorMarcio H. Malogolowkin MD
Department of Pediatrics, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorSteven W. Thorpe MD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Search for more papers by this authorCorresponding Author
R. Lor Randall MD
Department of Orthopaedic Surgery, University of California-Davis, Sacramento, California, USA
Correspondence R. Lor Randall, Department of Orthopaedic Surgery, University of California-Davis, 4860 Y St, Suite 3800, Sacramento, CA 95817, USA.
Email: [email protected]
Search for more papers by this authorAbstract
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.
CONFLICTS OF INTEREST
The authors declare no conflicts of interest.
Open Research
DATA AVAILABILITY STATEMENT
Data are available at https://seer.cancer.gov/data-software/
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