Ewing Sarcoma in Adults: Demystifying Experience from a Developing Nation

Date 24 November 2018
Event ESMO Asia 2018 Congress
Session Poster display - Cocktail
Topics Cancer Care Delivery in Low Resource Environments
Presenter RAVI Ambalathandi
Citation Annals of Oncology (2018) 29 (suppl_9): ix124-ix128. 10.1093/annonc/mdy443
Authors R.C. Ambalathandi, S. Gundeti, B. Stalin, M.L. Konatam, N.R. Palukuri, R.P. Yedla
  • Medical Oncology, Nizam's Institute of Medical Sciences, 500082 - Hyderabad/IN

Abstract

Background

Ewing sarcoma (ES) is more common in children and relatively rare in adults. Adult ES has poor prognosis than children. Treatment approaches for adults have been extrapolated from pediatric experience. Data on adult Ewing sarcoma is very few because of its rarity in adults. The present study was done to analyze the clinical profile and outcome of adult Ewing sarcoma.

Methods

Between 2010 and 2017, a total of 54 ES patients with age more than 18 years were analyzed. Survival analysis was done by plotting Kaplan Meier curves. Univariate analysis was done using SPSS software.

Results

A total of 54 patients were analyzed of which 32 were males and 22 were females. Pain and swelling were the most common symptoms at presentation seen in 76% and 42% patients respectively. Forty-one patients had osseous origin of primary and 13 had extraosseous primary. The most common site of primary tumor was extremity (46%) followed by chest wall (26%), axial skeleton (18.6%) and other sites (9.4%). Size of primary tumor was less than 8 cm in 24(44%) patients and more than 8cm in 24(44%) patients. Evaluable data was present in 48 patients, of which 30 patients (62.5%) had localized disease and 18(37.5%) had metastatic disease at presentation. Elevated LDH at presentation was seen in 14(26%). Of 30 patients with localized disease, 15(50%) received neoadjuvant chemotherapy, 10 (33.3%) underwent surgery upfront and 1 (3.3%) received radiotherapy. Four (13.4%) patients did not receive any treatment. The 3-year overall survival in patients with localized ES, who received some form of therapy, was 83.4%. Of 18 patients with metastasis, 11 patients had lung metastasis,3 had bone, bone marrow and brain metastasis, and 4 had multiple sites of metastasis. The 3-year overall survival in this group was 13%.

Conclusions

Outcomes with multimodality therapy in adult ES patients with localized disease is comparable to that of pediatric cohort. However, metastatic disease in adult has poor survival when compared to that of children.

Editorial acknowledgement

Clinical trial identification

Legal entity responsible for the study

Nizam\'s Institute of Medical Sciences.

Funding

Has not received any funding.

Disclosure

All authors have declared no conflicts of interest.