Skip metastases in appendicular Ewing sarcoma: relationship to distant metastases at diagnosis, chemotherapy response and overall survival,Skeletal Radiology

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Skip metastases in appendicular Ewing sarcoma: relationship to distant metastases at diagnosis, chemotherapy response and overall survival
Skeletal Radiology ( IF 1.9 ) Pub Date : 2022-09-14 , DOI: 10.1007/s00256-022-04180-9
Asif Saifuddin ₁ , Maria Michelagnoli ₂ , Ian Pressney ₁

Affiliation

Objective

To identify in appendicular Ewing sarcoma (ES), if skip metastases (SM) are associated with distant metastases at presentation, response to neoadjuvant chemotherapy and overall outcome.

Materials and method

Patients with appendicular ES from 2007 to 2021 who had whole-bone MRI to identify SM were included in the study. Patient demographics included age/gender, bone involved, the presence of SM, longitudinal tumour length, presence of extra-osseous disease and its axial depth if present from whole-bone MRI and lung metastases and distant bone metastases from staging studies. Response to neoadjuvant chemotherapy from resection specimens and overall survival were noted. Comparison of these factors between patients with and without SM was undertaken.

Results

Ninety-five patients (66 males; 29 females: mean age 15.8 years; range 5–48 years) were included. On whole-bone MRI, 80 (84.2%) patients had no SM and 15 (15.8%) patients had one or more SM. Of patients without a SM, lung metastases were present in 16 (21%), distant bone metastases in 7 (11%), while 51 (75%) had a good response to chemotherapy compared with 7 (50%), 3 (27%), and 10 (77%), respectively, in patients with a SM. SM were significantly associated with lung metastases (p = 0.02), but not with distant skeletal metastases (p = 0.13), chemotherapy response (p = 0.88), tumour length (p = 0.47), presence of (p = 0.15) or axial depth of extra-osseous disease (p = 0.4). SM were associated with a significantly poorer survival (p = 0.007) and three times greater risk of death during follow-up.

Conclusions

In appendicular ES, the identification of a SM is associated with the presence of lung metastases at presentation and poorer survival.

中文翻译：

四肢尤文肉瘤的跳跃转移：诊断时与远处转移、化疗反应和总生存期的关系

客观的

为了识别四肢尤文肉瘤 (ES)，如果跳跃转移 (SM) 与就诊时的远处转移、对新辅助化疗的反应和总体结果相关。

材料与方法

该研究纳入了 2007 年至 2021 年患有四肢 ES 并进行全骨 MRI 以识别 SM 的患者。患者人口统计学包括年龄/性别、受累骨骼、是否存在 SM、纵向肿瘤长度、是否存在骨外疾病及其轴向深度（如果存在于全骨 MRI 和肺转移以及分期研究中的远处骨转移）。记录了切除标本对新辅助化疗的反应和总生存期。对有和没有 SM 的患者进行了这些因素的比较。

结果

包括 95 名患者（66 名男性；29 名女性：平均年龄 15.8 岁；范围 5-48 岁）。在全骨 MRI 上，80 名 (84.2%) 患者没有 SM，15 名 (15.8%) 患者有一处或多处 SM。在没有 SM 的患者中，16 例 (21%) 存在肺转移，7 例 (11%) 存在远处骨转移，而 51 例 (75%) 对化疗反应良好，而 7 例 (50%)、3 例 (27) %), 和 10 (77%), 分别在 SM 患者中。SM 与肺转移 ( p = 0.02) 显着相关，但与远处骨骼转移 ( p = 0.13)、化疗反应 ( p = 0.88)、肿瘤长度 ( p = 0.47)、是否存在 ( p = 0.15) 或轴向无关骨外病变的深度 ( p = 0.4）。SM 与明显较差的生存率 ( p = 0.007) 和随访期间死亡风险高出三倍相关。