Overall survival comparison between pediatric and adult Ewing sarcoma of bone and adult nomogram construction: a large population-based analysis

Abstract

BackgroundEwing sarcoma (ES) is a common primary bone tumor in children. Our study aimed to compare overall survival (OS) between pediatric and adult bone ES patients, identify independent prognostic factors and develop a nomogram for predicting OS in adult patients with ES of bone.MethodsWe retrospectively analyzed data for the 2004–2015 period from the Surveillance, Epidemiology, and End Results (SEER) database. To guarantee well-balanced characteristics between the comparison groups, propensity score matching (PSM) was used. Kaplan–Meier (KM) curves were used to compare OS between pediatric and adult patients with ES of bone. Univariate and multivariate Cox regression analyses were used to screen independent prognostic factors for ES of bone, and a prognostic nomogram was constructed by using the factors identified. The prediction accuracy and clinical benefit were evaluated using receiver operating characteristic (ROC) curves, areas under the curves (AUCs), calibration curves, and decision curve analysis (DCA).ResultsOur results showed that adult ES patients had lower OS than younger ES patients. Age, surgery, chemotherapy, and TNM stage were independent risk factors for bone ES in adults and were used to develop a nomogram. AUCs for 3-, 5-, and 10-year OS were 76.4 (67.5, 85.3), 77.3 (68.6, 85.9) and 76.6 (68.6, 84.5), respectively. Calibration curves and DCA results indicated excellent performance for our nomogram.ConclusionWe found that ES pediatric patients have better OS than adult ES patients, and we constructed a practical nomogram to predict the 3-, 5- and 10-year OS of adult patients with ES of bone based on independent prognostic factors (age, surgery, chemotherapy, T stage, N stage and M stage).

Novel biomarkers in bone sarcomas — diagnosis, treatment selection, and clinical trials

“…Nomograms are prognostic instruments that integrate determinant variables and yield a numerical likelihood of a clinical result [32]. Numerous nomograms have been established also for the prognosis of patients with chondrosarcoma [33], osteosarcoma, and Ewing sarcoma [34][35][36]. These nomograms also utilize such factors as the occurrence of surgery, chemotherapy, or the patient's age.…”

“…These nomograms also utilize such factors as the occurrence of surgery, chemotherapy, or the patient's age. The age at diagnosis is also an independent predictor of increased survival -patients with Ewing sarcoma, aged less than 28 years have a favorable prognosis [36], as well as patients with osteosarcoma, younger than 24 years [37].…”