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KMID : 0613319960020010038
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Journal of the Korean Bone and Joint Tumor Soceity
1996 Volume.2 No. 1 p.38 ~ p.46
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Role of Surgery in Ewing´s Sarcoma Treatment
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Jeon Dae-Geun
Lee Jong-Seok
Kim Sug-Jun
Park Hyun-Soo
Jang Jin-Dae
Lee Soo-Yong
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Abstract
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The traditional methodology in Ewing`s sarcoma was chemotherapy and radiotherapy. Recently surgery is reemerging as an important therapeutic tool some paper report increased survival with it. The purpose of this nonrandomized study is to evaluate our result of Ewing`s sarcoma with surgery, retrospectively. We experienced 30 cases for seven years and among them 6 were extraskeletal.In location,axial was 10 cases and peripheral was 20. By Enneking`s classification,state IIB was 26 cases and IIB was 4. Eighteen patients took operation,chemotherapy and/or radiotherapy,and remaining twelve
took chemotherapy and/or radiotherapy only.Type of operation was limb salvage in 16 cases and amputation 2. Average dosage of radiation was 45.1Gy. Six kinds of chemotherapeutic regimen were used,but among them main protocols were Ifosfamide-Adriamycin(17 cases) and IESS(Cytoxan, Adriamycin,Methotrexate,Vincristine:8 cases). Complications were as follws. In operation group, there were 3 local recurrence and one case of nonunion. In nonoperated group,one local recurrence and one pancytopenia resulting in death. Average follow up was 29.7 months. Kaplan-Meir`s ten year actuarial survival rate for the whole 30 cases was 26.8%. Signficant difference in survival exists between cental and peripheral lesions(p=0.05,by log rank test). Types of chemotherapy and surgery itself showed no significance. But surgery is important in function and local control. More intensive chemotherapeutic regimen to prevent distant metastasis and combined surgery and radiotherapy may be needed in Ewing`s sarcoma.
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KEYWORD
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Ewing`s sarcoma, Surgery, Survival
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