Comorbidities rather than older age define outcome in adult patients with tumors of the Ewing sarcoma family
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Comorbidities rather than older age define outcome in adult patients with tumors of the Ewing sarcoma family. / Striefler, Jana Käthe; Schmiester, Maren; Brandes, Franziska; Dörr, Anne; Pahl, Stefan; Kaul, David; Rau, Daniel; Dobrindt, Eva-Maria; Koulaxouzidis, Georgios; Bullinger, Lars; Märdian, Sven; Flörcken, Anne.
In: CANCER MED-US, Vol. 11, No. 17, 09.2022, p. 3213-3225.Research output: SCORING: Contribution to journal › SCORING: Journal article › Research › peer-review
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TY - JOUR
T1 - Comorbidities rather than older age define outcome in adult patients with tumors of the Ewing sarcoma family
AU - Striefler, Jana Käthe
AU - Schmiester, Maren
AU - Brandes, Franziska
AU - Dörr, Anne
AU - Pahl, Stefan
AU - Kaul, David
AU - Rau, Daniel
AU - Dobrindt, Eva-Maria
AU - Koulaxouzidis, Georgios
AU - Bullinger, Lars
AU - Märdian, Sven
AU - Flörcken, Anne
N1 - © 2022 The Authors. Cancer Medicine published by John Wiley & Sons Ltd.
PY - 2022/9
Y1 - 2022/9
N2 - 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.
AB - 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.
KW - Adult
KW - Aged
KW - Antineoplastic Combined Chemotherapy Protocols/therapeutic use
KW - Bone Neoplasms/drug therapy
KW - Comorbidity
KW - Humans
KW - Middle Aged
KW - Prognosis
KW - Progression-Free Survival
KW - Retrospective Studies
KW - Sarcoma, Ewing/pathology
U2 - 10.1002/cam4.4688
DO - 10.1002/cam4.4688
M3 - SCORING: Journal article
C2 - 35297222
VL - 11
SP - 3213
EP - 3225
JO - CANCER MED-US
JF - CANCER MED-US
SN - 2045-7634
IS - 17
ER -
