The role of surgery and resection margins in the treatment of Ewing's sarcoma

Because of the enormous progress in surgery in the treatment of patients wi th tumors, the current study analyzed the influence of wide surgical resect ion margins on the outcome of patients with Ewing's sarcoma. Between 1980 a nd 1994, 86 patients were treated with systemic therapy and surgery (biopsy in six patients, tumor resection in 80 patients). Forty-four patients also had radiation therapy. The 5-year overall survival was 56.8% (5-year disea se-free survival, 59.4%). The 5-year overall survival after radical or wide resection was 60.2% (5-year disease-free survival, 58.2%), in comparison w ith 40.1% (46.7%) after marginal or intralesional resection. Two patients w ith inadequate resection margins had local recurrences. In addition to the influence of neoadjuvant chemotherapy for higher survival rates (5-year ove rall survival with a good response was 80.2% versus 41.7% with a poor respo nse), adequate surgical margins significantly affect the outcome for patien ts with Ewing's sarcoma.