OUTCOME IN 43 CHILDREN PRESENTING WITH METASTATIC EWING SARCOMA - THEST-JUDE-CHILDRENS-RESEARCH-HOSPITAL EXPERIENCE, 1962 TO 1992

The purpose of this work was to review the St. Jude Children's Researc h Hospital experience of patients presenting with metastatic Ewing sar coma over a 30-year period. Forty-three of 212 cases of Ewing sarcoma presented with metastases at diagnosis. These patients were analyzed t o determine whether primary tumor site or size, metastatic site(s), or advances in therapy have had a positive impact on survival. The overa ll survival for our 43 patients was 35% (95% confidence intervals, 20% to 50%). Comparing patients treated prior to 1979 with those treated after 1979, the overall survival was significantly different (P = 0.00 02). Comparing overall survival between pelvic and non-pelvic primarie s (P = 0.24), among metastatic sites (P = 0.83), and between tumors me asuring >8 cm in diameter to tumors measuring <8 cm in diameter (P = 0 .12), no significant differences were observed. Approximately one-thir d of patients presenting with metastatic Ewing sarcoma may achieve lon g-term survival. Children with metastatic Ewing sarcoma may benefit fr om clinical trials which intensify the doses of doxorubicin, and the h ighly effective combination of ifosfamide/etoposide. (C) 1996 Wiley-Li ss, Inc.