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CLINICAL AND THERAPEUTICAL ASPECTS OF EWING SARCOMA IN CHILDREN AND ADOLESCENTS – A SINGLE CENTER EXPERIENCE
Ewing sarcoma, a rare malignancy of childhood and adolescence, has become a model of progress in diagnosis and treatment through long-standing research efforts in multinational clinical trials. The aim of this study is to present the specific diagnostic and therapeutic approach of Ewing sarcoma in children and adolescents.
Materials and method. A retrospective and prospective analysis of all Ewing sarcoma treated in a large referral center – the Department of Pediatric and Orthopedic Surgery, Maria Sklodowska Curie Emergency Hospital for Children, between 2005 and 2012 is presented. A total of 28 patients were identified, 19 boys and 9 girls, with a male to female ratio of 2.11:1. Diagnosis was based on the result of the histopathological examination of tumor biopsy.
Results. The mean age of the patients was 12.3 years (range 3-19 years) and the mean tumor volume was 197.96 cm3 (range 8-1,200 cm3 ). 8/28 patients (28.57%) had metastatic disease at diagnosis, mainly in the lungs (7 cases). Chemotherapy was administred to 26 patients (92.85%). Local therapy consisted of surgery in all patients and of surgery combined with radiation, in 5 patients. After a mean follow-up of 51.5 months, 9 patients have died, 17 (60.71%) patients are alive and free of disease and 2 patients are alive with disease.
Conclusions. The management of a child or adolescent with Ewing sarcoma is best carried out in a specialized center under the care of a multidisciplinary team, in order to obtain the best outcome for the patient. Ewing sarcoma has a high mortality rate in Romania, especially because of late diagnosis.
Keywords: Ewing sarcoma, malignant bone tumors, children and adolescents