gms | German Medical Science

27th German Cancer Congress Berlin 2006

German Cancer Society (Frankfurt/M.)

22. - 26.03.2006, Berlin

Ewing tumour over the age of forty

Meeting Abstract

  • corresponding author presenting/speaker Uta Dirksen - Pädiatrische Hämatologie und Onkologie, Universitätsklinikum Münster, Deutschland
  • Andreas Ranft - Pädiatrische Hämatologie und Onkologie, Universitätsklinikum Münster
  • Michael Paulussen - Pädiatrische Hämatologie und Onkologie,Universitätsklinikum beider Basel,CH
  • Heribert Jürgens - Pädiatrische Hämatologie und Onkologie, Universitätsklinikum Münster

27. Deutscher Krebskongress. Berlin, 22.-26.03.2006. Düsseldorf, Köln: German Medical Science; 2006. DocPO622

The electronic version of this article is the complete one and can be found online at: http://www.egms.de/en/meetings/dkk2006/06dkk730.shtml

Published: March 20, 2006

© 2006 Dirksen et al.
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Outline

Text

Decreasing incidence of Ewing tumour in patients over 40 years (pts >40) and the expectation that such patients may not tolerate aggressive chemotherapy results in their exclusion from current treatment trials. Thus, little is known on clinical appearance and outcome in pts >40. Ewing tumour trials between 1981 and 2005 were analysed for data of pts >40. Pts >40 were first registered in EICESS 92 (18 pts), and their number increased in EURO-E.W.I.N.G. 99 (38 pts). Only 27% of this group were registered as regular study patients, 72%, as “patient under observation”. Patients under observation are registered and treated similarly to study patients, but are excluded from randomization. Main reasons for exclusion were delay >45 days from diagnostic biopsy to registration or more than one cycle of non-protocol chemotherapy. Furthermore, data from 36 off-study patients receiving various treatment regimens were available for analysis. Mean age was 48 years (SD=6.8), with 48 males and 44 females. Proof of diagnosis was by histopathology with expression of CD99. and molecular pathology was available in 19%. The average tumour size was <100ml in 31% and >100ml in 68% of EICESS 92 pts, and <200ml in 56% and >200ml in 44% of EURO-E.W.I.N.G. 99 pts. 81% reported no symptoms or mild complaints at the time of diagnosis, 13.5% were impaired, and 5% were confined to bed. Remarkably, 30% of pts >40y were diagnosed for extraosseous ET, which is uncommon in younger patients with approx. 7% [1]. Also, central tumour site was seen more often with 72%. 37% showed metastases at diagnosis. Chemotherapy was recorded in 32 pts: 76% received treatment acc. to protocol, 24% had modified chemotherapy. Response to chemotherapy was assessed in 21 pts, with 67% of good responders. No treatment-related death was documented. 16 pts had adequate surgical removal while surgery was marginal or intralesional in 9. Radiotherapy was recorded in 29 patients, which was given for primary local therapy in 4, because of marginal or intralesional surgery in 9, and for palliative treatment in 16pts.

Overall survival was 0.65 and 0.59 (CI95% +/-0.16), EFS was 0.54 and 0.45 (+/-0.16) at 2 and 3 years, respectively (N=41).


References

1.
Paulussen M, Fröhlich B, Jürgens H. Ewing tumour: incidence, prognosis and treatment options. Paediatr Drugs. 2001;3:899