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Poor response to neoadjuvant chemotherapy predictive of recurrence in Ewing sarcoma

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Patients with localized Ewing sarcoma who have a poor pathologic or radiologic response to neoadjuvant chemotherapy are more likely to experience recurrence, according to a study.

Out of the 94 patients with Ewing sarcoma retrospectively analyzed in this study, 21 patients experienced recurrence, including 4 local, 14 distant, and 3 combined.

Overall, recurrence-free survival at 5-years was 75.6% and 70.5% at 10-years. Independent predictors of recurrence according to multivariable analysis included age at diagnosis and tumor size and radiological tumor size change during neoadjuvant chemotherapy.

Pulmonary metastases were present in 82% of patients who had distant recurrence; in 53% of patients with recurrence, pulmonary metastases were the only identifiable site of disease.

“Suboptimal tumor size reduction following chemotherapy provides a means to risk-stratify patients who do not undergo definitive resection,” the authors concluded.

Stachelek GC, Ligon JA, Vogel J, et al. Predictors of recurrence and patterns of initial failure in localized ewing sarcoma: A contemporary 20-year experience. Sarcoma. 2021;2021:6681741. DOI: 10.1155/2021/6681741. PMID: 33953640; PMCID: PMC8068528.