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Rainov NG, Haritonov D, Heidecke V. Long-Term Survival after Primary Ewing's Sarcoma of the Skull with Intracranial Extension. J Neurol Surg A Cent Eur Neurosurg 2024; 85:215-220. [PMID: 37939826 DOI: 10.1055/s-0043-1776264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2023]
Abstract
BACKGROUND AND OBJECTIVE Primary Ewing's sarcoma of the skull is a very rare malignant neoplasm, predominantly occurring in children and adolescents. We describe here the clinical, neuroradiologic, and histopathologic features of a patient with primary Ewing's sarcoma of the skull and discuss the standards of therapy for this type of tumor. CLINICAL PRESENTATION This 18-year-old male patient presented with a primary Ewing's sarcoma of the skull, involving the dura of the frontal and parietal lobes of the left cerebral hemisphere. He was treated with gross total surgical excision of tumor, skull reconstruction, chemotherapy, and irradiation. Twelve years after the surgery, the patient has no evidence of local recurrence or distant metastases. Radical surgical excision of the primary tumor with safety margins is thought to play a role in the favorable clinical course. CONCLUSION The presented case is the longest surviving patient after treatment of primary Ewing's sarcoma of the skull bone. This rare type of tumor may allow better survival rates under adequate management than sarcoma elsewhere in the body.
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Affiliation(s)
- Nikolai G Rainov
- MVZ Wirbelsäulenzentrum München-Taufkirchen, München, Germany
- Department of Neurosurgery, University Hospital Heart and Brain, Pleven, Bulgaria
| | - Dimitar Haritonov
- Department of Neurosurgery, University Hospital Heart and Brain, Pleven, Bulgaria
| | - Volkmar Heidecke
- Department of Neurosurgery, Universitätsklinikum Augsburg, Augsburg, Germany
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2
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Jakovljevic S, Arsovic N, Dudvarski Z, Radivojevic N, Jovanovic K, Mladenovic N, Babac S. Primary Cervical Extraosseous Ewing's Sarcoma Originated from the Sternocleidomastoid Muscle: A Case Report and Review of the Literature. Case Rep Otolaryngol 2024; 2024:8867131. [PMID: 38435319 PMCID: PMC10904673 DOI: 10.1155/2024/8867131] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/14/2024] [Accepted: 02/17/2024] [Indexed: 03/05/2024] Open
Abstract
Extraosseous Ewing's sarcoma is extremely rare in the soft tissues of the neck, especially in the sternocleidomastoid muscle. It usually manifests clinically as a rapidly growing mass that shows great potential for local spread. The aim of this paper is to present a rare case of еxtraosseous Ewing's sarcoma in the sternocleidomastoid muscle. To the best of our knowledge, this is the first case of extraskeletal Ewing's sarcoma at this location. The patient was admitted to our clinic because of a neck tumefaction. The computerized tomography finding showed a tumor mass, most of which was in the V region of the neck, measuring 40 × 27 × 35 mm. Pathohistological and immunohistochemical findings showed that it was Ewing's sarcoma. Unfortunately, the patient passed away nine months after the initial diagnosis. Extraosseous Ewing sarcoma is a rare, fast-growing malignant tumor manifesting histomorphological similarities to bone Ewing's sarcoma. Most reports state that extraosseous Ewing sarcoma has a worse prognosis than skeletal. Extraosseous Ewing sarcoma should be borne in mind in the differential diagnosis of soft tissue tumors of the neck.
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Affiliation(s)
- Sasa Jakovljevic
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia
- University Clinical Center of Serbia, Clinic of Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
| | - Nenad Arsovic
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia
- University Clinical Center of Serbia, Clinic of Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
| | - Zoran Dudvarski
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia
- University Clinical Center of Serbia, Clinic of Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
| | - Nemanja Radivojevic
- University of Belgrade, Faculty of Medicine, Belgrade, Serbia
- University Clinical Center of Serbia, Clinic of Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
| | - Katarina Jovanovic
- University Clinical Center of Serbia, Clinic of Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
| | - Neda Mladenovic
- University Clinical Center of Serbia, Clinic of Otorhinolaryngology and Maxillofacial Surgery, Belgrade, Serbia
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3
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Bellut N, Lutz CM, Lesnik M, Dridi SM, Aerts I, Ejeil AL. Ewing's Sarcoma of Mandible: A Case Report with Review of Literature. Int J Clin Pediatr Dent 2024; 17:187-190. [PMID: 39184881 PMCID: PMC11339479 DOI: 10.5005/jp-journals-10005-2723] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/27/2024] Open
Abstract
Background Ewing sarcoma (ES), a rare malignancy, comprises whatever the age, 4-15% of all primary bone tumors. It represents 1% of all malignant tumors in children and is the fourth most common bone malignancy after myeloma, osteosarcoma, and chondrosarcoma. Case description A 12-year-old boy came to the Oral Surgery Department of Bretonneau Hospital referred by his dentist with a rapidly evolving swelling in the left mandibula for 6 weeks, which was initially diagnosed as a facial cellulitis. Cone beam computed tomography (CBCT) showed a poorly defined, expansile, and osteolytic tumor on the left side of the mandible. Clinical and radiographic findings were in favor of an aggressive primitive bone tumor. A mandibular biopsy under general anesthesia was performed in the Department of Surgical Oncology at Institut Curie in Paris, revealing an ES. Conclusion Mandibular ES can mimic dental infections when swelling is the main clinical manifestation, which can lead to a delayed diagnosis. A correlation between clinical, radiological, histopathological, and immunohistochemical with cytogenetics is needed to confirm the diagnosis. Moreover, smaller tumors have better survival.Dentists must therefore be aware of the clinical signs of ES in order to quickly refer patients to a specialized department. How to cite this article Bellut N, Lutz CM, Lesnik M, et al. Ewing's Sarcoma of Mandible: A Case Report with Review of Literature. Int J Clin Pediatr Dent 2024;17(2):187-190.
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Affiliation(s)
- Nicolas Bellut
- Department of Maxillofacial and Oral Surgery, Saint-Joseph Hospital, Paris, France
| | - Claire Manon Lutz
- Faculty of Odontology, Department of Oral Surgery, Hôpital Bretonneau AP-HP, Paris, France
| | - Maria Lesnik
- Department of ENT-Head and Neck Surgery, Curie Cancer Institute, APHP, Paris, France
| | - Sophie-Myriam Dridi
- Faculty of Odontology, Department of Periodontology, Institute of Oral Medicine Riquier, Côte d'Azur, CHU Nice, France
| | - Isabelle Aerts
- Department of Oncology, Institut Curie, Oncology Center SIREDO, Paris, France
| | - Anne-Laure Ejeil
- Faculty of Odontology, Department of Oral Surgery, Paris Cité, Hôpital Bretonneau AP-HP, Paris France
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4
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Ahmadi MS, Sheida F, Ameri A, Javadinia SA, Farahani F, Soltaninia O, Moaddab Shoar L, Sedighi Pashaki A, Gharib MH, Abbasi R, Keshtpour Amlashi Z. Ewing's Sarcoma of Mandible: Practical Approach to a Challenging Case. Case Rep Oncol 2022; 15:927-935. [PMID: 36636676 PMCID: PMC9830304 DOI: 10.1159/000525608] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2022] [Accepted: 06/09/2022] [Indexed: 11/11/2022] Open
Abstract
As a rare entity, sarcomas of the head and neck are challenging cases. In this paper, we represent a unique case of Ewing sarcoma of mandible, serving as an example of multidisciplinary team importance in a developing country.
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Affiliation(s)
| | - Fateme Sheida
- Cancer Immunology Project (CIP), Universal Scientific Education and Research Network (USERN), Tehran, Iran,Student Research Committee, School of Medicine, Hamadan University of Medical Sciences, Hamadan, Iran
| | - Ahmad Ameri
- Shahid Beheshti University of Medical Sciences, Tehran, Iran
| | | | | | | | | | | | | | - Rohollah Abbasi
- Hamadan University of Medical Sciences, Hamadan, Iran,*Rohollah Abbasi,
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5
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Bielack SS. Systemic treatment for primary malignant sarcomas arising in craniofacial bones. Front Oncol 2022; 12:966073. [PMID: 36158667 PMCID: PMC9492845 DOI: 10.3389/fonc.2022.966073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2022] [Accepted: 08/22/2022] [Indexed: 12/05/2022] Open
Abstract
Introduction Craniofacial bones may be the site of origin of various sarcomas. We review the various malignancies affecting this region of the body and attempt to put systemic treatment approaches into perspective. Material and methods Non-systematic literature review Results Conventional types of osteosarcoma, Ewing sarcoma, and chondrosarcoma are the most frequent bone sarcomas occurring in craniofacial region, but variants may occur. The tumors’ biologies and the resulting treatment strategies vary distinctly. As a general rule, local control remains paramount regardless of histology. The efficacy of antineoplastic chemotherapy varies by type of malignancy. It is clearly indicated in Ewing sarcoma and related tumors, potentially of benefit in high-grade osteosarcoma, undifferentiated pleomorphic sarcoma, dedifferentiated and mesenchymal chondrosarcoma, and of no proven benefit in the others. Conclusions Various histologies demand various and distinct treatment approaches, with local control remaining paramount in all. The efficacy of systemic treatments varies by type of tumor. Prospective trials would help in all of these to better define systemic treatment strategies.
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Affiliation(s)
- Stefan S. Bielack
- Pediatrics 5 (Oncology, Hematology, Immunology), Center for Pediatric, Adolescent and Women’s Medicine, Stuttgart Cancer Center, Klinikum Stuttgart–Olgahospital, Stuttgart, Germany
- Department of Pediatric Hematology and Oncology, University Children’s Hospital Muenster, Muenster, Germany
- *Correspondence: Stefan S. Bielack,
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6
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Urdang ZD, Geltzeiler MN, Hargunani CA. Sinonasal Ewing's sarcoma: Recognition and management of a rare disease. OTOLARYNGOLOGY CASE REPORTS 2021. [DOI: 10.1016/j.xocr.2021.100344] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Assessment of Risk of Bias in Osteosarcoma and Ewing's Sarcoma Randomized Controlled Trials: A Systematic Review. Curr Oncol 2021; 28:3771-3794. [PMID: 34677240 PMCID: PMC8534836 DOI: 10.3390/curroncol28050322] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2021] [Revised: 09/14/2021] [Accepted: 09/23/2021] [Indexed: 12/03/2022] Open
Abstract
Aim: The aim of this study was to systematically assess the risk of bias in osteosarcoma and Ewing’s sarcoma (ES) randomized controlled trials (RCT) and to examine the relationships between bias and conflict of interest/industry sponsorship. Methods: An OVID-MEDLINE search was performed (1976–2019). Using the Cochrane Collaboration guidelines, two reviewers independently assessed the prevalence of risk of bias in different RCT design domains. The relationship between conflicts of interest and industry funding with the frequency of bias was examined. Results: 73 RCTs met inclusion criteria. Prevalence of low-risk bias domains was 47.3%, unclear-risk domains 47.8%, and 4.9% of the domains had a high-risk of bias. Domains with the highest risk of bias were blinding of participants/personnel and outcome assessors, followed by randomization and allocation concealment. Overtime, frequency of unclear-risk of bias domains decreased (χ2 = 5.32, p = 0.02), whilst low and high-risk domains increased (χ2 = 8.13, p = 0.004). Studies with conflicts of interest and industry sponsorships were 4.2 and 3.1 times more likely to have design domains with a high-risk of bias (p < 0.05). Conclusion: This study demonstrates that sources of potential bias are prevalent in both osteosarcoma and ES RCTs. Studies with financial conflicts of interest and industry sponsors were significantly more likely to have domains with a high-risk of bias. Improvements in reporting and adherence to proper methodology will reduce the risk of bias and improve the validity of the results of RCTs in osteosarcoma and ES.
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8
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Bouaoud J, Schouman T, Bertolus C. Comment to: "Head and neck osteosarcomas: An analysis of treatment trends and survival outcomes in the United States (2004-2016)". Head Neck 2021; 43:4018-4019. [PMID: 34505730 DOI: 10.1002/hed.26870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2021] [Accepted: 09/02/2021] [Indexed: 11/06/2022] Open
Affiliation(s)
- Jebrane Bouaoud
- Sorbonne Université, Paris, France.,Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Thomas Schouman
- Sorbonne Université, Paris, France.,Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France
| | - Chloe Bertolus
- Sorbonne Université, Paris, France.,Department of Maxillo-Facial Surgery, Hôpital Pitié-Salpêtrière, Assistance Publique des Hôpitaux de Paris, Paris, France
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9
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Malignant fibrous histiocytoma of the floor of mouth: a case report and review of the literature. JOURNAL OF STOMATOLOGY, ORAL AND MAXILLOFACIAL SURGERY 2021; 123:e106-e111. [PMID: 34224923 DOI: 10.1016/j.jormas.2021.06.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/07/2021] [Revised: 06/23/2021] [Accepted: 06/29/2021] [Indexed: 11/22/2022]
Abstract
Malignant fibrous histiocytoma (MFH) is the most common soft tissue sarcoma in late adulthood and usually occurs in the limbs, trunk, and peritoneum. Less than 10% of MFH cases occur in the head and neck region. The clinical manifestations and pathological features of MFH are atypical, and it is difficult to make a clinical diagnosis. We describe a rare case of MFH of the floor of mouth and provide our diagnosis and treatment experiences. Through this review, we also evaluate the origin, World Health Organization (WHO) classification, clinical presentations, pathological features, treatment methods, and prognosis of MFH. MFH may originate from fibroblasts or primitive mesenchymal cells. MFH was defined as undifferentiated pleomorphic sarcoma in the 2002 WHO classification of bone and soft tissue tumors. The most common manifestation of MFH is a painless enlarging nodule, often without overlying epidermal ulcers. Jaw lesions are usually found after displays of swelling, pain, paresthesia, and loose teeth. MFH is composed of pleomorphic spindle cells, usually with hemorrhage, necrosis, and lymphocyte infiltration. The main treatment method is surgical resection. Moreover, radiotherapy and chemotherapy have certain auxiliary effects. The local recurrence and distant metastasis of MFH are common, and the prognosis is poor. Therefore, determining the histopathological features of MFH and conducting appropriate immunohistochemical examinations are crucial in establishing the correct diagnosis. In-depth study is required in order to have a better understanding of head and neck MFH.
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10
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Bouaoud J, Temam S, Galmiche L, Cozic N, Bolle S, Belhous K, Kolb F, Qassemyar Q, Bidault F, Couloigner V, Picard A, Le Deley MC, Mahier-Ait Oukhatar C, Gaspar N, Kadlub N. Head and neck Ewing sarcoma: French surgical practice analysis pleads for surgery centralization. J Craniomaxillofac Surg 2021; 50:439-448. [DOI: 10.1016/j.jcms.2021.01.030] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2020] [Revised: 11/07/2020] [Accepted: 01/31/2021] [Indexed: 12/26/2022] Open
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11
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Fuchs J, Schmidt A, Warmann SW, Rodeberg DA. Treatment Concepts and Challenges in Nonrhabdomyosarcoma Soft Tissue Sarcomas. Surg Oncol Clin N Am 2021; 30:355-371. [PMID: 33706905 DOI: 10.1016/j.soc.2020.11.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Pediatric nonrhabdomyosarcoma soft tissue sarcomas (NRSTSs) encompass a heterogeneous group of mesenchymal tumors with more than 50 histologic variants. The incidence of NRSTS is greater than rhabdomyosarcoma; however, each histologic type is rare. The treatment schema for all NRSTSs is largely surgical. The treatment is a risk-adapted approach based on tumor size, localization, tumor grade, and presence of metastases. Low-grade tumors are mainly managed by surgery alone, whereas for high-grade tumors a multimodal treatment concept is necessary. The multimodal treatment consists of tumor biopsy, chemotherapy, local treatment (surgery ± radiotherapy), and immunotherapy in selected conditions.
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Affiliation(s)
- Joerg Fuchs
- Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Hoppe-Seyler-Str. 3, Tuebingen 72076, Germany.
| | - Andreas Schmidt
- Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Hoppe-Seyler-Str. 3, Tuebingen 72076, Germany
| | - Steven W Warmann
- Department of Pediatric Surgery and Pediatric Urology, University Children's Hospital Tuebingen, Hoppe-Seyler-Str. 3, Tuebingen 72076, Germany
| | - David A Rodeberg
- Department of Surgery, Brody School of Medicine, East Carolina University, 600 Moye Boulevard, Greenville, NC 27834, USA
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12
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Torabi SJ, Bourdillon A, Salehi PP, Kafle S, Mehra S, Rahmati R, Judson BL. The epidemiology, surgical management, and impact of margins in skull and mandibular osseous-site tumors. Head Neck 2020; 42:3352-3363. [PMID: 32743892 DOI: 10.1002/hed.26389] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2019] [Revised: 04/14/2020] [Accepted: 07/07/2020] [Indexed: 11/11/2022] Open
Abstract
OBJECTIVE The aim of the study was to characterize the epidemiology and treatment outcomes of head and neck (HN) osseous-site tumors. METHODS Descriptive analyses and multivariate Cox regressions were performed to analyze the effect of surgery on overall survival (OS) utilizing the National Cancer Database (2004-2016). RESULTS Of 2449 tumors, surgery was utilized in 84.5% of cases. OS was worse in osteosarcoma (5-year OS: 53.4% [SE: 2.5%]) compared with cartilage tumors (5-year OS: 84.6% [SE: 1.8%]) (log-rank P < .001). Treatment regimens that included surgery were associated with improved OS on multivariate analysis (hazard ratio [HR] 0.495 [95% CI: 0.366-0.670]). Positive margins were found in 40.8% of cases, and associated with decreased OS in osteosarcomas (HR 1.304 [0.697-2.438]). CONCLUSION Treatment that included surgery was associated with an increased OS within our cohort of HN osseous-site tumors, although the rates of positive margins were >40%. These findings may be limited by inherent selection bias in the database.
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Affiliation(s)
- Sina J Torabi
- Department of Surgery (Division of Otolaryngology), Yale University School of Medicine, New Haven, Connecticut, USA
| | - Alexandra Bourdillon
- Department of Surgery (Division of Otolaryngology), Yale University School of Medicine, New Haven, Connecticut, USA
| | - Parsa P Salehi
- Department of Surgery (Division of Otolaryngology), Yale University School of Medicine, New Haven, Connecticut, USA
| | - Samipya Kafle
- Department of Surgery (Division of Otolaryngology), Yale University School of Medicine, New Haven, Connecticut, USA
| | - Saral Mehra
- Department of Surgery (Division of Otolaryngology), Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Cancer Center, New Haven, Connecticut, USA
| | - Rahmatullah Rahmati
- Department of Surgery (Division of Otolaryngology), Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Cancer Center, New Haven, Connecticut, USA
| | - Benjamin L Judson
- Department of Surgery (Division of Otolaryngology), Yale University School of Medicine, New Haven, Connecticut, USA.,Yale Cancer Center, New Haven, Connecticut, USA
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13
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MacDonald D, Martin M, Nguyen C. Malignant lesions in the anterior maxilla. Clin Radiol 2020; 75:497-506. [DOI: 10.1016/j.crad.2019.09.133] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2019] [Accepted: 09/23/2019] [Indexed: 12/16/2022]
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14
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Liu Z, Zhu F, Cao W, Sun J, Zhang C, He Y. Surgical treatment of pediatric rhabdomyosarcoma in the parameningeal-nonparameningeal region. J Craniomaxillofac Surg 2020; 48:75-82. [PMID: 31902716 DOI: 10.1016/j.jcms.2019.12.002] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2019] [Revised: 11/01/2019] [Accepted: 12/02/2019] [Indexed: 02/08/2023] Open
Abstract
OBJECTIVES Rhabdomyosarcoma (RMS) involving the parameningeal-nonparameningeal region (PNP) is relatively rare in pediatric patients (PPs). The current study aimed to report the outcomes of RMS-PNP-PPs who received surgical resection combined with concurrent flap reconstruction. METHODS A retrospective study was conducted concerning RMS-PNP-PPs who received combined skull-maxillofacial resection with flap reconstruction during the period from 2012 to 2016. Predictive factors for recurrence-free survival (RFS), metastasis-free survival (MFS), and overall survival (OS) were preliminarily identified by Kaplan-Meier analysis. RESULTS A total of 16 RMS-PNP-PPs were finally enrolled; recurrence, metastasis and death were found in 7, 7 and 5 patients, respectively. Following surgical ablation involving the skull base and maxillofacial region, reconstruction was performed with a local flap in 9 patients, a latissimus dorsi flap in 3 patients, and an anterolateral thigh flap in 4 patients. Through univariate analysis, we demonstrated that the primary site + surgical margins, postoperative RT/CT + Ki-67/Bcl-2 IHC, and surgical margins + Ki-67/Bcl-2 IHC could be used as the preliminarily prognostic factors for RFS, MFS and OS, respectively. CONCLUSIONS RMS-PNP-PPs showed poor prognosis even when surgical resection combined with flap reconstructions was performed. Achieving a clear surgical margin and good conduction of postoperative RT/CT should be taken into consideration to acquiring a better surgical outcome.
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Affiliation(s)
- Zhonglong Liu
- Department of Oral Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Fengshuo Zhu
- Department of Oral Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Wei Cao
- Department of Oral Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Jian Sun
- Department of Oral Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Chenping Zhang
- Department of Oral Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
| | - Yue He
- Department of Oral Maxillofacial & Head and Neck Oncology, Shanghai Ninth People's Hospital Affiliated to Shanghai Jiao Tong University School of Medicine, Shanghai, 200011, China.
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15
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Bouaoud J, Temam S, Cozic N, Galmiche-Rolland L, Belhous K, Kolb F, Bidault F, Bolle S, Dumont S, Laurence V, Plantaz D, Tabone MD, Marec-Berard P, Quassemyar Q, Couloigner V, Picard A, Gomez-Brouchet A, Le Deley MC, Mahier-Ait Oukhatar C, Kadlub N, Gaspar N. Ewing's Sarcoma of the Head and Neck: Margins are not just for surgeons. Cancer Med 2018; 7:5879-5888. [PMID: 30449071 PMCID: PMC6308064 DOI: 10.1002/cam4.1801] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2018] [Revised: 09/05/2018] [Accepted: 09/06/2018] [Indexed: 12/18/2022] Open
Abstract
Background, Methods To describe the characteristics, treatments (systemic/local), and outcome (oncological/functional) of French patients with head and neck Ewing's sarcomas (HNES) registered in the Euro‐Ewing 99 (EE99) database. Specific patient‐level data were reviewed retrospective. Results Forty‐seven HNES patients in the EE99 database had a median age of 11 years, 89% had bone tumors (skull 55%, mandible 21%, maxilla 11%), 89% had small tumors (<200 mL), and they were rarely metastatic (9%). Local treatment was surgery radiotherapy (55%), exclusively surgery (28%), or radiotherapy (17%). Metastatic relapses occurred in five patients with high relapse risk factors (metastasis at diagnosis, poor histological response, large tumors). Local progression/relapses (LR) after exclusive radiotherapy occurred in three patients with persistent extra‐osseous residue and in four patients considered R0 margins (postchemotherapy surgery, without postoperative radiotherapy [PORT]), reclassified by pathological review as R1a. Pathological review reclassified 72% of R0 margins: 11/18 to R1a and 2/18 to R2. Five patients had confirmed R0 margins after postchemotherapy surgery without PORT and had no LR Eight patients had R2 margins (initial surgery without previous chemotherapy, with PORT) and had no LR With a median follow‐up of 9.3 years, the 3‐year LR rate, EFS, and OS were 84.8%, 78.6%, and 89.3%, respectively. Among the 5‐year survivors, 88% had long‐term sequelae. Conclusion To optimize HNES management, patients should be treated from diagnosis in expert centers with multidisciplinary committees to discuss treatment strategy (type of surgery, need for PORT) and validate surgical margins.
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Affiliation(s)
- Jebrane Bouaoud
- Unit of maxillofacial and Plastic Surgery, Necker-Enfants Malades, Paris, France
| | - Stephane Temam
- Unit of Head and Neck Surgery, Gustave Roussy, Villejuif, France
| | - Nathalie Cozic
- Department of Biostatistics, Gustave Roussy, Villejuif, France
| | - Louise Galmiche-Rolland
- Department of Pathology, Necker-Enfants Malades, Paris, France.,University Paris Descartes, Paris, France
| | - Kahina Belhous
- University Paris Descartes, Paris, France.,Department of Pediatric Radiology, Necker-Enfants Malades, Paris, France
| | - Frederic Kolb
- Plastic and Reconstructive Surgery Department, Gustave Roussy, Villejuif, France
| | | | - Stephanie Bolle
- Radiation Oncology Department, Gustave Roussy, Villejuif, France
| | - Sarah Dumont
- Department of medical oncology, Gustave Roussy, Villejuif, France
| | | | - Dominique Plantaz
- Department of Pediatric Hematology-Oncology, University Hospital Centre of Grenoble, Grenoble, France
| | | | - Perrine Marec-Berard
- Department of Pediatric Oncology, Léon Bérard Cancer Center, Institute for Paediatric Haematology and Oncology, Lyon, France
| | - Quentin Quassemyar
- Plastic and Reconstructive Surgery Department, Gustave Roussy, Villejuif, France
| | - Vincent Couloigner
- University Paris Descartes, Paris, France.,Unit of Otolaryngology and Head and Neck Surgery, Necker-Enfants Malades, Paris, France
| | - Arnaud Picard
- Unit of maxillofacial and Plastic Surgery, Necker-Enfants Malades, Paris, France.,University Paris Descartes, Paris, France
| | | | - Marie-Cécile Le Deley
- Centre Oscar Lambret, Lille, France.,CESP, INSERM, Fac. de médecine - Univ. Paris-Sud, Université Paris-Saclay, Villejuif, France
| | | | - Natacha Kadlub
- Unit of maxillofacial and Plastic Surgery, Necker-Enfants Malades, Paris, France.,University Paris Descartes, Paris, France
| | - Nathalie Gaspar
- Department of Oncology for Child and Adolescents, Gustave Roussy, Villejuif, France
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