Ewing Sarcoma Treatment (PDQ®): Treatment - Health Professional Information [NCI] - General Information
Table 1. Characteristics of Children With Extraosseous Ewing Sarcoma and Skeletal Ewing Sarcoma continued...
The following are not considered to be adverse prognostic factors for Ewing sarcoma:
- Pathologic fracture: Pathologic fractures do not appear to be a prognostic factor.
- Histopathology: The degree of neural differentiation is not a prognostic factor in Ewing sarcoma.[33,34]
- Molecular pathology: The EWS-FL1 translocation associated with Ewing sarcoma can occur at several potential breakpoints in each of the genes which join to form the novel segment of DNA. Once thought to be significant, two large series have shown the EWS-FL1 translocation breakpoint site is not an adverse prognostic factor.[36,37]
Treatment response factors to preoperative therapy
Multiple studies have shown that patients with minimal or no residual viable tumor after presurgical chemotherapy have a significantly better event-free survival compared with patients with larger amounts of viable tumor.[38,39,40,41] Female gender and younger age predict a good histologic response to preoperative therapy. For patients who receive preinduction and postinduction chemotherapy positron emission tomography (PET) scans, decreased PET uptake following chemotherapy correlated with good histologic response and better outcome.[43,44] Patients with poor response to presurgical chemotherapy have an increased risk for local recurrence.
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