Trends in incidence of Ewing sarcoma of bone in India – Evidence from the National Cancer Registry Programme (1982–2011)

Abstract

BackgroundEwing sarcoma is a malignant tumour found mainly in childhood and adolescence. The present study aims at analyzing the data on Ewing sarcoma cases of bone from the National Cancer Registry Programme, India to provide incidence, patterns, and trends in the Indian population.Materials and MethodsThe data of five Population Based Cancer Registries (PBCR) of Bangalore, Mumbai, Chennai, Bhopal and Delhi over 30 years period (1982– 2011) were used to calculate the Age Specific and Age Standardized Incidence Rates (ASpR and ASIR), and trends in incidence was analyzed by linear and Joinpoint Regression.ResultsEwing sarcoma comprised around 15 % of all bone malignancies. Sixty-eight percent were 0–19 years, with 1.6 times risk of tumour in bones of limbs as compared to other bones. The highest incidence rate (per million) was in the 10–14 years age group (male −4.4, female −2.9) with significantly increasing trend in ASpR observed in both sexes. Pooled ASIR per million for all ages was higher in male (1.6) than female (1.0) with an increasing rate ratio of ASIR with increase in age. Trend of pooled ASIR for all ages was significantly increased in both sexes. Twelve percent cases were reported in ≥30 years of age.ConclusionThis paper has described population based measurements on burden and trends in incidence of skeletal Ewing in India. These may steer further research questions on the clinical and molecular epidemiology to explain factors associated with the increasing incidence of Ewing sarcoma bone observed in India.

A nomogram for determining the disease-specific survival in Ewing sarcoma: a population study

“…Table 1 presents that most of the patients were male, white, had a marital status of single/domestic partner, diagnosed in the 2000s or 2010s, treated with surgery, and treated with chemotherapy; these results were consistent with previous research findings [16–19]. Although ES has the highest incidence in people under the age of 30 [20], the prognosis is better for those with a younger age of onset and worse for those with a higher age of onset [1]. Similarly, in our nomogram (Fig.…”

“…The long-term survival rate of ES for nonmetastatic disease at presentation has improved from 10 to 15% to 60–70% since the early 1990s through the application of multimodality approaches, including surgery, radiotherapy, and neoadjuvant chemotherapy [12, 22, 23]. However, ES exhibits an aggressive behavior that often results in lung metastasis, which is a poor prognostic factor given that only 20% of patients with metastases can survive for a long time [1, 2, 20]. The early identification of high-risk ES patients is helpful in providing adjuvant treatment or trials.…”

“…A well-developed clinical nomogram is a popular decision-making tool that can be used to predict the outcome of an individual and benefit both clinicians and patients [24]. Nomograms in many studies [2, 16, 17, 20, 25] indicate that being black and aged appear to be high-risk factors. However, small size tumor and surgery treatment demonstrate improved outcomes in DSS for ES.…”

<p>Identification of key genes and pathways in Ewing’s sarcoma patients associated with metastasis and poor prognosis</p>

“…It is a devastating, poorly differentiated, and high-grade osteolytic disease threatening human health severely 1,2. Statistically, ES is a rare, aggressive bone neoplasm, and around 2.9 people per million encountered with ES annually worldwide, and predominantly appeared in childhood and adolescence 3,4. ES mainly occurs in bone and surrounding soft tissue characterized by a highly aggressive small round blue cell malignant neoplasm 5,6.…”

Ewing Sarcoma in Nepal Treated With Combined Chemotherapy and Definitive Radiotherapy

“…Two epidemiologic studies are reported from Iran and India. 5,6 To our knowledge, three studies, all with a retrospective design, have reported on clinical outcomes after multimodality treatment. 7-9…”