Japanese journal of clinical oncology · 2026
Distinct epidemiology and treatment outcomes between skeletal and extraskeletal Ewing sarcoma in Japan: a population-based study.
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Toda Yu, Ogura Koichi, Morizane Chigusa, Satake Tomoyuki, Iwata Shintaro, Kobayashi Eisuke, Takemori Toshiyuki, Kondo Hiroya, Muramatsu Shudai, Higashi Takahiro, Kawai Akira
Аннотация
BACKGROUND: Ewing sarcoma arises at both skeletal (SES) and extraskeletal (EES) sites; however, whether the anatomical origin influences outcomes in current practice remains uncertain. This study compared clinical characteristics, treatment, and survival rates of patients with SES and EES in a large nationwide Japanese cohort.
METHODS: We analyzed patients diagnosed with Ewing's sarcoma between 2016 and 2019 in Japan, classified as having SES or EES, using a population-based cancer registry. Demographics, stage, treatment, hospital characteristics, and overall survival (OAS) were evaluated using chi-square tests, Kaplan-Meier estimates, and log-rank analyses.
RESULTS: We identified 505 patients with ES: 211 with SES and 294 with EES. Patients with EES were significantly older than those with SES (P < .001). Chemotherapy (97.7% vs. 74.9%, P < .001) and radiotherapy (36.6% vs. 27.1%, P = .024) were administered more frequently in the SES group. Three-year OAS rate was 62.3%, 73.5% for SES, and 54.7% for EES, with significantly worse survival in EES group (P < .001). Favorable prognostic factors included younger age, localized stage, surgery, chemotherapy, treatment at certified institutions, higher hospital volume, and female sex among patients with EES.
CONCLUSIONS: In this nationwide cohort, EES presented at older ages, received less chemotherapy, and demonstrated inferior survival compared to SES, despite a similar stage distribution. Patient background, hospital type, and volume influenced the outcomes. These findings underscore the need for equitable multimodal therapy delivery, particularly for patients with EES.
METHODS: We analyzed patients diagnosed with Ewing's sarcoma between 2016 and 2019 in Japan, classified as having SES or EES, using a population-based cancer registry. Demographics, stage, treatment, hospital characteristics, and overall survival (OAS) were evaluated using chi-square tests, Kaplan-Meier estimates, and log-rank analyses.
RESULTS: We identified 505 patients with ES: 211 with SES and 294 with EES. Patients with EES were significantly older than those with SES (P < .001). Chemotherapy (97.7% vs. 74.9%, P < .001) and radiotherapy (36.6% vs. 27.1%, P = .024) were administered more frequently in the SES group. Three-year OAS rate was 62.3%, 73.5% for SES, and 54.7% for EES, with significantly worse survival in EES group (P < .001). Favorable prognostic factors included younger age, localized stage, surgery, chemotherapy, treatment at certified institutions, higher hospital volume, and female sex among patients with EES.
CONCLUSIONS: In this nationwide cohort, EES presented at older ages, received less chemotherapy, and demonstrated inferior survival compared to SES, despite a similar stage distribution. Patient background, hospital type, and volume influenced the outcomes. These findings underscore the need for equitable multimodal therapy delivery, particularly for patients with EES.