Survivorship Analysis for Osteosarcoma and Ewing’s Sarcoma in Children and Adolescents at a Single Pediatric Institution: Comparison to SEER Data - Abstract
Primary malignant bone tumors account for approximately 6% of all childhood malignancies. Osteosarcoma (OS) and Ewing’s sarcoma (ES) are the most common and have an annual incidence of 8.7 per million under the age of 20 years. The mean 5-year survival for OS and ES has been 61% and 60% respectively. The survival for OS and ES has not significantly improved for past 20 years.
We examined the cases of OS and ES, treated at Children’s Hospital of New Orleans (CHNOLA) from 1999-2012. Comparison to national survival data from the Survival, Epidemiological and End Results (SEER) study was done. The goal of our study was to demonstrate any difference in survival of our patient population compared to national data.
Results: Of the 44 patients diagnosed and treated as either OS or ES, 25 (57%) were OS and 19 (43%) were ES. The mean age of diagnoses for OS was 14 years and for ES was 12 years. Overall survival for all cases was 85%, which was superior to the reported SEER 5-year survival of 68.7 % for malignant bone tumors for ages 0-19 years from 2003 to 2009.
Survival was not affected by patients’ age, gender, race or timing of surgery for removal of primary tumor. All non-survivors had metastatic disease at presentation, which was an adverse prognostic factor (p=0.002). Additionally, positive tumor margins at time of surgery (p=0.008) and decreased amount of tumor necrosis post chemotherapy (p=0.001) negatively affected survival.
Conclusion: Overall survival of pediatric patients with bone tumors was better than SEER data. Presence of metastatic disease and poor response to chemotherapy based on tumor necrosis and positive margins were found to be adverse prognostic factors.