Ewing's sarcoma of bone: Oncologic and functional results

Abstract

This paper describes 29 patients with Ewing's sarcoma of bone treated between 1975 and 1990 at the University of Nijmegen Hospital, Nijmegen, The Netherlands. Osteomyelitis was the primary diagnosis in 24%. Treatment consisted of chemotherapy in combination with surgery and/or radiotherapy. Nine patients received radiotherapy only; five of them died of disease. Five patients underwent an intralesional excision; four of them died of disease. Twelve patients underwent a wide excision; there is no evidence of disease in any of them. Three patients underwent a radical disarticulation; all died of disease. The disease-free survival at 1.5 years was 66%. This figure at 5 years was 55%. After wide excision and reconstruction in tumors of expendable, femoral or radial bones good functional results were obtained in all cases.

Delay in Diagnosis and Its Effect on Clinical Outcome in High‐grade Sarcoma of Bone: A Referral Oncological Centre Study

“…High-grade bone sarcomas are rare neoplasms; 102 lesions were seen in our referral oncology center over 12 years. The present study provides a valuable addition to data of other published Dutch series on outcomes of highgrade bone sarcomas [19][20][21][22] . Furthermore, this report includes 8.3% of all patients with high-grade bone sarcomas who underwent orthopaedic oncological treatment in the Netherlands during that 12 years 23 .…”

Evaluating physical function in an adolescent bone tumor population

“…Five studies 43–46 used the 1987 functional scoring system developed by the MSTS 47 with the overall functional score being comprised of: range of motion, pain, stability, deformity, strength, functional activity, and emotional acceptance. A new functional scoring system was developed by the MSTS in 1993 48 and has become extremely popular in clinical research 10,14,15,17–22,25,26,42,49–51. It is brief (completed in 5 min) and simple (six items) and based on three factors pertinent to the patient as a whole (pain, emotional acceptance, function) and three specific to the affected extremity (lower: supports, walking, gait; upper: hand positioning, dexterity, lifting ability).…”

“…There are no standardized measures of physical function for these patients because current measures have been validated and tested only with adults. Further, most researchers have examined physical functioning in survivors of bone tumors, not those undergoing treatment 10–22. Although “survivor” is rarely defined, most studies evaluated subjects at least 2 years after diagnosis 10,12–18,20–25.…”

Bone sarcoma incidence in the Netherlands

“…These series are based on cohorts from several hospitals in various countries and regions, with different treatment regimens. Several single-institution cohorts have also been described in the Netherlands [16,17]. Importantly, diagnosis and treatment of bone sarcomas have become increasingly centralised in four cooperating bone tumour centres in the past two decades in order to optimise treatment strategies and survival.…”