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Comorbidities rather than older age define outcome in adult patients with tumors of the Ewing sarcoma family

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Item Type:Article
Title:Comorbidities rather than older age define outcome in adult patients with tumors of the Ewing sarcoma family
Creators Name:Striefler, J.K., Schmiester, M., Brandes, F., Dörr, A., Pahl, S., Kaul, D., Rau, D., Dobrindt, E.M., Koulaxouzidis, G., Bullinger, L., Märdian, S. and Flörcken, A.
Abstract:BACKGROUND: Ewing family of tumors (EFT) is rarely diagnosed in patients (pts) over the age of 18 years (years), and data on the clinical course and the outcome of adult EFT pts is sparse. METHODS: In this retrospective analysis, we summarize our experience with adult EFT pts. From 2002 to 2020, we identified 71 pts of whom 58 were evaluable for the final analysis. RESULTS: Median age was 31 years (18-90 years). Pts presented with skeletal (n = 26), and extra-skeletal primary disease (n =32). Tumor size was ≥8 cm in 20 pts and 19 pts were metastasized at first diagnosis. Between the age groups (≤25 vs. 26-40 vs. ≥41 years) we observed differences of Charlson comorbidity index (CCI), tumor origin, as well as type and number of therapy cycles. Overall, median overall survival (OS) was 79 months (95% confidence interval, CI; 28.5-131.4 months), and median progression-free survival (PFS) 34 months (95% CI; 21.4-45.8 months). We observed a poorer outcome (OS, PFS) in older pts. This could be in part due to differences in treatment intensity and the CCI (<3 vs. ≥3; hazard ratio, HR 0.334, 95% CI 0.15-0.72, p = 0.006). In addition, tumor stage had a significant impact on PFS (localized vs. metastasized stage: HR 0.403, 95% CI 0.18-0.87, p = 0.021). CONCLUSIONS: Our data confirms the feasibility of intensive treatment regimens in adult EFT pts. While in our cohort outcome was influenced by age, due to differences in treatment intensity, CCI, and tumor stage, larger studies are warranted to further explore optimized treatment protocols in adult EFT pts.
Keywords:Adult Patients, Charlson Comorbidity Index, Chemotherapy, Ewing's Sarcoma, Sarcoma
Source:Cancer Medicine
ISSN:2045-7634
Publisher:Wiley
Volume:11
Number:17
Page Range:3213-3225
Date:September 2022
Official Publication:https://doi.org/10.1002/cam4.4688
PubMed:View item in PubMed

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