The Largest Single Institutional Experience On Extraosseous Ewing'S Sarcoma

To analyze the treatment strategies, outcomes and factors impacting these outcomes in extraosseous Ewing’s Sarcoma (EOES) and to add onto the literature on this disease which is already at a premium. A review of the hospital database over a period of 10 years yielded a total of 109 patients listed under EOES title. Out of these a total of 25 patients were ineligible for the final analysis due to incomplete medical records. Demographic and clinical characteristics were reported using descriptive statistics. Overall survival (OS) was taken from the time of diagnosis to death. Patients who were alive or lost to follow up were censored from the survival analysis. A total of 12 clinical and treatment related variables were taken into univariate analysis (UVA). Factors which were significant or showing a trend towards significance on UVA were taken up for multivariate analysis to arrive at the predictors of outcomes in EOES patients. Patients who defaulted on treatment or those in whom treatment had to be abandoned were also taken into the survival analysis as per recommendations in developing countries. Further a cluster analysis was done by taking stage at presentation, surgery (Y/N), status of resection margin, response to chemotherapy (CT) and radiotherapy given or not as input variables. Cluster analysis was done in a quest to find a subgroup within the entire cohort which would have a better survival outcome as compared to other clusters. SPSS version 23 was used for statistical analysis Descriptive statistics have been summed up in the table (Y/N) = YES/NO, C = CHEMOTHERAPY, S = SURGERY, R = RADIOTHERAPY, n = number of patients Chest wall (22), lower extremity (17) and paraspinal area (13) were the common sites involved. The most common symptom at presentation was localized swelling (49). The median time from appearance of symptom to presentation at clinic was 2 months. Overall survival of the entire cohort at 5 years was 48 percent. Disease stage at presentation had a significant impact (P value<0.01) on estimated overall survival (localized 60 months versus 36 months in metastatic stage). Cluster analysis in SPSS generated a total of 4 clusters by combining the input variables in different permutations. Patients with localized stage at presentation, good response to chemotherapy, negative resection margin and no adjuvant RT had a median 5year survival of 69 months. Our study highlights that optimal results in EOES are obtained with judicious use of trimodality treatment and it also adds significantly onto the scarce literature on this sub-type of sarcoma.Abstract 2024; TableParametersNMean/Percent +SDAge8422.84 ± 12.73Gender Male Female58 2669% 31%Stage Localized Metastatic72 1286% 14%Surgery (Y/N)62/2274%/26%Resection margin R0 R151 1182% 18%Response on HPE Good Poor47 1575% 25%Modality of Treatment C C+S C+R C+S+R Alternative medicine2 37 19 25 12.38% 44% 22.6% 29.8% 1.22% Open table in a new tab