Ewings sarcoma in pediatric population of North India: Demographics, outcome & prognostic factors

Abstract

Background: Ewings sarcoma is relatively rare and accounts for a 3–4% of childhood cancer. The data of Ewings sarcoma is scarce in North India and so the study was planned to find out the demographics, outcome and prognostic factors of Ewings sarcoma. Methods: This is a retrospective study conducted in the Department of Pediatrics, Pediatric Oncology unit at a tertiary care centre (KGMC, Lucknow) in North India. All patients of age 1–16 years with biopsy and IHC proven Ewings sarcoma during 2015–2020 were included in the study. Parameters were noted and follow up was done till December 2021. Statistical analysis was done by Microsoft Excel and GraphPad Prism 10. Overall survival was assessed using Kaplan Meir Survival Analysis. P value < 0.05 was considered significant. Results: 75 patients i.e.4.1 % of the total were diagnosed with ES. Median age of patients was 10 years. 37.35 % had metastasis at presentation. 32 % were defaulters (abandoned and not taking treatment). Extremity ES constituted 46.7 % of the patient. 29.4 % patients relapsed. The overall survival of the whole cohort was 23.5 % and OS of localised disease was 42.3 %. OS of patients with respect to various sites failed to show any significance. Staging of disease have shown to be affecting outcome. Conclusion: Proportion of Ewings sarcoma was in accordance with the world's data but the survival outcome was low at our centre primarily due to delayed presentation translating to metastatic disease at diagnosis and abandonment issues along with defaults in treatment. Conducting focussed group discussions, awareness sessions, caregivers counselling and educating them about disease might help in curbing these factors.

Keywords

• Bone Oncology
• PNET
• Low middle income countries
• Pediatric bone cancers
• Askins tumor