Complications in long‐term survivors of Ewing sarcoma

BACKGROUND Multimodality treatment has dramatically improved the outcome of patients with Ewing sarcoma. However, there appears to be little information concerning treatment‐related complications in patients who are long‐term survivors. METHODS Forty‐one patients with Ewing sarcoma who were treated between 1960–1980 and who survived the disease by at least 20 years were included in the current study. In a retrospective analysis, all complications related to the multimodality treatment of Ewing sarcoma were assessed. RESULTS The patient group was comprised of 17 men and 24 women, with a mean age at the time of presentation of 16.8 years (range, 5–51 years). Approximately 20% of the lesions were located in the pelvis. All but 9 patients (78%) received chemotherapy as part of their treatment. The overall follow‐up period averaged 25 years (range, 20–36 years). All except 1 patient were alive at the time of final follow‐up, with the latter patient dying of radiation‐induced secondary malignancy after 33 years. Only 17 patients (41%) were found to be free of any complication. These included metastases, local recurrence, secondary malignancies, pathologic fractures, and radiation‐associated and chemotherapy‐associated morbidities. CONCLUSIONS Although the patients in the current study were treated successfully in terms of surviving an aggressive tumor, the high complication rate in this group of long‐term survivors is noteworthy and indicates that long‐term follow‐up should be mandatory. Cancer 2003;98:2687–92. © 2003 American Cancer Society. DOI 10.1002/cncr.11891 Multimodality treatment has been reported to dramatically improve the outcome of patients with Ewing sarcoma. However, little information concerning treatment‐related complications in patients who are long‐term survivors is available. In the current study, 41 patients with Ewing sarcoma who survived the disease by at least 20 years were included and, in a retrospective analysis, all complications related to the multimodality treatment of Ewing sarcoma were assessed.