Five-year results in Ewing's sarcoma. The Scandinavian Sarcoma Group experience with the SSG IX protocol

Elomaa, Inkeri; Blomqvist, Carl; Sæter, Gunnar; Akerman, M; Stenwig, Elisabeth; Wiebe, Thomas; Björk, Olle; Alvegård, Thor

doi:10.1016/s0959-8049(00)00028-9

Cited by 101 publications

(76 citation statements)

References 25 publications

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“…This result was comparable to the reports from other major series in ESFT of bone among Euro-American populations. 6,8,9,[23][24][25][26][27] Compared with the international variation in incidence, there was no considerable difference in the ratio of men to women, age distribution, or site distribution between Japanese patients and EuroAmerican patients (Table 2). Parkin et al also noted that there was no suggestion of any geographic or ethnic difference in the site distribution.…”

Section: Discussionmentioning

confidence: 94%

“…Although some studies demonstrated no significant differences in the rates of local recurrence and/or survival between patients who received radiotherapy alone and patients who underwent surgery, 9,26,33 other studies demonstrated that surgery improved clinical outcomes significantly. 34,35 Results from 1058 patients who were treated on Cooperative Ewing Sarcoma Study 81 (CESS 81), CESS 86, and European Intergroup Cooperative Ewing Sarcoma Study 92 demonstrated that local control and EFS among patients who received definitive radiotherapy was significantly lower than EFS among patients who underwent surgery with or without receiving additional radiotherapy, although the former subgroup of patients represented a negatively selected population with unfavorable tumor sites.…”

Section: Discussionmentioning

confidence: 99%

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Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

Obata

Ueda

Kawai

et al. 2007

Cancer

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BACKGROUND.Ewing sarcoma family of tumors (ESFT) of bone is extremely rare in Japan. The objectives of the current study were to assess the clinical outcome and prognostic factors of patients with ESFT of bone in Japan and to compare them between Euro‐American and Japanese populations.METHODS.The authors conducted a retrospective analysis of 243 patients who were treated for ESFT of bone in Japan between 1981 and 2003. Local therapy was surgery in 35% of patients, surgery combined with radiotherapy in 40% of patients, radiotherapy alone in 22% of patients, and no local treatment in 3% of patients. All but 3 patients received various regimens of multidrug chemotherapy.RESULTS.The median patient age was 16 years. The primary disease sites were the trunk in 53% of patients and the extremities in 47% of patients. Forty‐one patients had metastases at presentation. The median follow‐up was 66 months. A univariate survival analysis demonstrated that patients who had metastases at presentation, primary site in the trunk, age ≥16 years, tumor size ≥10 cm, tumor that responded poorly to induction chemotherapy, and local treatment with radiotherapy alone had a significantly worse event‐free survival (EFS). A multivariate analysis further verified that the former 3 factors were significant adverse prognostic factors. Of 201 patients with localized disease, 45 patients who received current chemotherapy regimens that included ifosfamide and etoposide had a significantly better 5‐year EFS rate (67.6%) compared with other patients.CONCLUSIONS.The clinical outcome of patients with localized ESFT of bone in Japan has improved markedly with the use of current chemotherapy regimens that include ifosfamide and etoposide and has become comparable to the outcomes observed in other major series of Euro‐American patients. The prognostic factors are also almost identical. Cancer 2007 © 2007 American Cancer Society.

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Section: Discussionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

Obata

Ueda

Kawai

et al. 2007

Cancer

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“…Prior to 1990 patients with ES received conventional multiagent combination chemotherapy of moderate intensity (cyclofosfamide, doxorubicin, methotreaxate, bleomycin, dactinomycin and vincristine), and radiotherapy was given separately following the completion of chemotherapy (SSG IV) [10]. The subsequent SSG IX study added ifosfamide from the start of treatment, the local treatment was given earlier and the radiotherapy schedule was modified and integrated during chemotherapy (see below) [11]. In the present analysis, the SSG IV and similar regimens for Ewing's sarcoma were classified as of conventional intensity, whereas the SSG IX and similar regimens were classified as of high intensity.…”

Section: Chemotherapy Intensitymentioning

confidence: 99%

“…For osteosarcoma and MFH the decrease was related to a realization of a limited sensitivity to radiation, whereas for ES the decrease was due to an increase in the use of surgery for axial and pelvic tumours coupled with a documentation of surgical superiority over radiotherapy in achieving local control [12]. For ES patients who received radiotherapy the schedule was intensified in 1990 (protocol SSG IX), with hyperfractionated accelerated radiotherapy being closely integrated with chemotherapy [11].…”

Section: Radiotherapymentioning

confidence: 99%

Management of high-grade bone sarcomas over two decades: The Norwegian Radium Hospital experience

et al. 2006

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“…At this location, the patellar tendon often has to be resected together with the tumor [5,24,37]. Many patients with musculoskeletal tumors are young and active, and high cure rates have been reported as a result of the steadily increasing success of chemotherapy after its introduction in the late 1970s [15].…”

Section: Introductionmentioning

confidence: 99%

Extensor Function After Medial Gastrocnemius Flap Reconstruction of the Proximal Tibia

Jentzsch

Erschbamer

Seeli

et al. 2013

Clinical Orthopaedics &Amp; Related Research

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Background Reconstruction of the extensor mechanism after resection of the proximal tibia is challenging, and several methods are available. A medial gastrocnemius flap commonly is used, although it may be associated with an extensor lag. This problem also is encountered, although perhaps to a lesser extent, with other techniques for reconstruction of the extensor apparatus. It is not known how such lag develops with time and how it correlates with functional outcome. Questions/purposes We therefore (1) assessed patellar height with time, (2) correlated patellar height with function using the Musculoskeletal Tumor Society (MSTS) score, and (3) correlated patellar height with range of motion (ROM) after medial gastrocnemius flap reconstruction. Methods Sixteen patients underwent tumor endoprosthesis implantation and extensor apparatus reconstruction between 1997 and 2009 using a medial gastrocnemius flap after sarcoma resection of the proximal tibia. These patients represented 100% of the population for whom we performed extensor mechanism reconstructions during that time. The minimum followup was 2 years (mean, 5 years; range, 2-11 years). Fourteen patients were alive at the time of this study. We used the Blackburne-Peel Index to follow patellar height radiographically with time. Functional outcomes were assessed retrospectively using the MSTS, and ROM was evaluated through active extensor lag and flexion. Results Eleven patients had patella alta develop, whereby the maximal patellar height was reached after a mean of 2 years and then stabilized. More normal patellar height was associated with better functional scores, a smaller extensor lag, but less flexion; the mean extensor lag (and flexion) of patients with patella alta was 17°(and 94°) compared with only 4°(and 77°) without. Conclusions In our patients patella alta evolved during the first 2 postoperative years. Patella alta is associated with extensor lag, greater flexion, and worse MSTS scores.

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Five-year results in Ewing's sarcoma. The Scandinavian Sarcoma Group experience with the SSG IX protocol

Cited by 101 publications

References 25 publications

Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

Clinical outcome of patients with Ewing sarcoma family of tumors of bone in Japan

Management of high-grade bone sarcomas over two decades: The Norwegian Radium Hospital experience

Extensor Function After Medial Gastrocnemius Flap Reconstruction of the Proximal Tibia

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