Pediatric Hematology Oncology Journal (Mar 2025)
Current management of pulmonary relapse in Ewing sarcoma: A report from the Pediatric Surgical Oncology Research Collaborative
- Audra J. Reiter,
- Lynn Huang,
- Jennifer H. Aldrink,
- Brian T. Craig,
- Andrew M. Davidoff,
- Lindsay J. Talbot,
- Jordan Coggins,
- Jasmine Smith,
- Katherine C. Bergus,
- Taleen A. MacArthur,
- Stephanie F. Polites,
- Roshni Dasgupta,
- Chloe Boehmer,
- Joseph Brungardt,
- Marcus M. Malek,
- Hannah N. Rinehardt,
- Zachary J. Kastenberg,
- Cameron M. Arkin,
- Antoine Gourmel,
- Nelson Piche,
- Marshall Wallace,
- Jiancong Liang,
- Harold N. Lovvorn, III,
- Robin T. Petroze,
- Gwendolyn Gillies,
- John P. Marquart,
- Kerri Becktell,
- Hau D. Le,
- Juan Favela,
- Barrie S. Rich,
- Richard D. Glick,
- Natashia M. Seemann,
- Jacob Davidson,
- Claire A. Wilson,
- Jonathan Roach,
- Erin G. Brown,
- Kathleen E. Doyle,
- Brian A. Coakley,
- Pamela Emengo,
- Pamela Merola,
- Christa N. Grant,
- Anuritha Tirumani,
- Elisabeth T. Tracy,
- Mary E. Moya-Mendez,
- Timothy B. Lautz
Affiliations
- Audra J. Reiter
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Northwestern Quality Improvement, Research, and Education in Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Lynn Huang
- Northwestern Quality Improvement, Research, and Education in Surgery, Northwestern University Feinberg School of Medicine, Chicago, IL, USA
- Jennifer H. Aldrink
- Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
- Brian T. Craig
- Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Andrew M. Davidoff
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA
- Lindsay J. Talbot
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA
- Jordan Coggins
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA
- Jasmine Smith
- Department of Surgery, St. Jude Children's Research Hospital, Memphis, TN, USA
- Katherine C. Bergus
- Division of Pediatric Surgery, Department of Surgery, Nationwide Children's Hospital, The Ohio State University College of Medicine, Columbus, OH, USA
- Taleen A. MacArthur
- Division of Pediatric Surgery, Mayo Clinic, Rochester, MN, USA
- Stephanie F. Polites
- Division of Pediatric Surgery, Mayo Clinic, Rochester, MN, USA
- Roshni Dasgupta
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, Cincinnati, OH, USA
- Chloe Boehmer
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, Cincinnati, OH, USA
- Joseph Brungardt
- Division of Pediatric General and Thoracic Surgery, Cincinnati Children's Hospital, Cincinnati, OH, USA
- Marcus M. Malek
- Division of Pediatric General and Thoracic Surgery, University of Pittsburgh, Pittsburg, PA, USA
- Hannah N. Rinehardt
- Division of Pediatric General and Thoracic Surgery, University of Pittsburgh, Pittsburg, PA, USA
- Zachary J. Kastenberg
- Division of Pediatric Surgery, Department of Surgery, University of Utah, Primary Children's Hospital, Salt Lake City, UT, USA
- Cameron M. Arkin
- Division of Pediatric Surgery, Department of Surgery, University of Utah, Primary Children's Hospital, Salt Lake City, UT, USA
- Antoine Gourmel
- Department of Pediatric Surgery, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Canada
- Nelson Piche
- Department of Pediatric Surgery, Centre Hospitalier Universitaire Sainte-Justine, University of Montreal, Montreal, Canada
- Marshall Wallace
- Department of Pediatric Surgery, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University, Nashville, TN, USA
- Jiancong Liang
- Department of Pediatric Surgery, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University, Nashville, TN, USA
- Harold N. Lovvorn, III
- Department of Pediatric Surgery, Monroe Carell Jr. Children's Hospital at Vanderbilt, Vanderbilt University, Nashville, TN, USA
- Robin T. Petroze
- Division of Pediatric Surgery, University of Florida, Gainesville, FL, USA
- Gwendolyn Gillies
- Division of Pediatric Surgery, University of Florida, Gainesville, FL, USA
- John P. Marquart
- Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Kerri Becktell
- Division of Pediatric Surgery, Department of Surgery, Medical College of Wisconsin, Milwaukee, WI, USA
- Hau D. Le
- Division of Pediatric Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Juan Favela
- Division of Pediatric Surgery, University of Wisconsin School of Medicine and Public Health, Madison, WI, USA
- Barrie S. Rich
- Division of Pediatric Surgery, Cohen Children's Medical Center, Zucker School of Medicine at Northwell/Hofstra, New Hyde Park, NY, USA
- Richard D. Glick
- Division of Pediatric Surgery, Cohen Children's Medical Center, Zucker School of Medicine at Northwell/Hofstra, New Hyde Park, NY, USA
- Natashia M. Seemann
- Division of Paediatric Surgery, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada
- Jacob Davidson
- Division of Paediatric Surgery, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada
- Claire A. Wilson
- Division of Paediatric Surgery, Children's Hospital, London Health Sciences Centre, London, Ontario, Canada
- Jonathan Roach
- Department of Pediatric Surgery, Children's Hospital Colorado, Aurora, CO, USA
- Erin G. Brown
- Division of Pediatric Surgery, University of California Davis, Sacramento, CA, USA
- Kathleen E. Doyle
- Division of Pediatric Surgery, University of California Davis, Sacramento, CA, USA
- Brian A. Coakley
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Pamela Emengo
- Department of Surgery, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Pamela Merola
- Division of Pediatric Hematology-Oncology, Department of Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
- Christa N. Grant
- Division of Pediatric Surgery, Westchester Medical Center, Valhalla, NY, USA
- Anuritha Tirumani
- Division of Pediatric Surgery, Westchester Medical Center, Valhalla, NY, USA
- Elisabeth T. Tracy
- Division of Pediatric Surgery, Duke Children's Hospital and Health Center, Durham, NC, USA
- Mary E. Moya-Mendez
- Division of Pediatric Surgery, Duke Children's Hospital and Health Center, Durham, NC, USA
- Timothy B. Lautz
- Division of Pediatric Surgery, Department of Surgery, Northwestern University Feinberg School of Medicine, Ann and Robert H. Lurie Children's Hospital of Chicago, Chicago, IL, USA; Corresponding author. 225 E Chicago Ave, Chicago, IL, 60611, USA.
- DOI
- https://doi.org/10.1016/j.phoj.2024.11.105
- Journal volume & issue
-
Vol. 10,
no. 1
pp. 20 – 23
Abstract
Background: Relapse occurs in 30–40 % of patients with localized Ewing sarcoma (EWS). Our objective was to describe the current management and outcomes of patients with initially localized EWS who experience first pulmonary relapse. Methods: This multi-center retrospective cohort study included patients ≤22 years old with initially localized EWS treated from 2007 to 2020 at 19 Pediatric Surgical Oncology Research Collaborative institutions, who developed pulmonary relapse. Kaplan-Meier analysis was performed. Results: Thirty-three patients with initially localized EWS developed pulmonary relapse at a median age of 17 (IQR 14; 20) years. Eleven (33 %) patients also had extra-pulmonary metastases (EPM) at relapse. Among the 22 (67 %) patients with pulmonary-only relapse, 10 (45 %) had solitary pulmonary nodules. Pulmonary metastasectomy was performed in 8/10 (80 %) patients with solitary pulmonary-only metastases, 5/12 (42 %) patients with multiple pulmonary-only metastases, and 2/11 (18 %) patients who also had EPM. Whole lung irradiation was administered in 7/10 (70 %) with solitary pulmonary-only metastases, 7/12 (58 %) with multiple pulmonary-only metastases, and 2/11 (18 %) with EPM. Rates of further pulmonary relapse/progression were similar between groups (p = 0.97). In Kaplan-Meier analysis, 3-year overall survival was 73 % with solitary pulmonary-only metastases, 40 % with multiple pulmonary-only metastases, and 23 % with EPM (p = 0.097). Conclusions: While survival for patients with relapsed EWS is poor, the subset of patients with solitary relapse confined to the lung are often good candidates for pulmonary metastasectomy and have a non-statistically significant trend towards improved survival outcomes.
Keywords
