Outcome of Ewing's sarcoma of the scapula-a long-term follow-up study.

OBJECTIVE

The aim of this study was to review our experience of managing Ewing's sarcoma of scapula and to identify features predictive of a good outcome.

HYPOTHESIS: Surgery and neo-adjuvant chemotherapy would have a better survival than surgery alone.

PATIENTS AND

METHODS

Between 1988 and 2018, 29patients, (14females and 15males) were treated at a single hospital: The median age at diagnosis was 17.6years (range: 2 to 51years). Of the 29cases, 3 were primary soft tissue Ewing's invading bone and remainder were bony sarcoma. Twenty three patients underwent surgery and 6 patients were managed non-operatively. All surgical resection specimens were classified according to Musculoskeletal Tumour Society based on surgical margins assessed by specialist musculoskeletal pathologists. The function was assessed using the Musculoskeletal Tumour Society Score.

RESULTS

The median follow-up for all patients was 10 years (range: 2 months to 30 years) and for survivors, median follow-up was 13.7 years (range: 18months to 30 years). The estimated disease-specific survival for all patients was 71.4% (95% CI 84.6-50.7%) at five years and 63% (95% CI 78.3-41.9%) at ten years. The estimated disease-specific survival for patients that underwent surgery was 86.5% (95% CI 95.5-63.7%) at five years and 81% (95% CI 92.5-56.9%) at ten years. The median MSTS score was 67.4%.

CONCLUSION

In this, the largest single series of patients with an Ewing's sarcoma of the scapula treated in a single hospital, those treated with surgery and neo-adjuvant chemotherapy had the best chance for survival compared to chemotherapy and/or radiotherapy alone. Local recurrence did not have an affect on survival.

LEVEL OF EVIDENCE: IV, retrospective study.