{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T02:54:35Z","timestamp":1747191275822,"version":"3.40.5"},"reference-count":51,"publisher":"Wiley","license":[{"start":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T00:00:00Z","timestamp":1710547200000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Projekt DEAL"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Sarcoma"],"published-print":{"date-parts":[[2024,3,16]]},"abstract":"<jats:p>Background. Ewing sarcoma (EwS) is a rare and highly malignant bone tumor primarily affecting children, adolescents, and young adults. The pelvis, trunk, and lower extremities are the most common sites, while EwS of the sacrum as a primary site is very rare, and only few studies focusing on this location are published. Due to the anatomical condition, local treatment is challenging in sacral malignancies. We analyzed factors that might influence the outcome of patients suffering from sacral EwS. Methods. We retrospectively analyzed data of the GPOH EURO-E.W.I.N.G 99 trial and the EWING 2008 trial, with a cohort of 124 patients with localized or metastatic sacral EwS. The study endpoints were overall survival (OS) and event-free survival (EFS). OS and EFS were calculated using the Kaplan\u2013Meier method, and univariate comparisons were estimated using the log-rank test. Hazard ratios (HRs) with respective 95% confidence intervals (CIs) were estimated in a multivariable Cox regression model. Results. The presence of metastases (3y-EFS: 0.33 vs. 0.68; <jats:inline-formula><a:math xmlns:a=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M1\"><a:mi>P<\/a:mi><a:mo>&lt;<\/a:mo><a:mn>0.001<\/a:mn><\/a:math><\/jats:inline-formula>; HR\u2009=\u20093.4, 95% CI 1.7 to 6.6; 3y-OS: 0.48 vs. 0.85; <jats:inline-formula><c:math xmlns:c=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M2\"><c:mi>P<\/c:mi><c:mo>&lt;<\/c:mo><c:mn>0.001<\/c:mn><\/c:math><\/jats:inline-formula>; HR\u2009=\u20094.23, 95% CI 1.8 to 9.7), large tumor volume (\u2265200\u2009ml) (3y-EFS: 0.36 vs. 0.69; <jats:inline-formula><e:math xmlns:e=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M3\"><e:mi>P<\/e:mi><e:mo>=<\/e:mo><e:mn>0.02<\/e:mn><\/e:math><\/jats:inline-formula>; HR\u2009=\u20092.1, 95% CI 1.1 to 4.0; 3y-OS: 0.42 vs. 0.73; <jats:inline-formula><g:math xmlns:g=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M4\"><g:mi>P<\/g:mi><g:mo>=<\/g:mo><g:mn>0.04<\/g:mn><\/g:math><\/jats:inline-formula>; HR\u2009=\u20092.1, 95% CI 1.03 to 4.5), and age \u226518\u2009years (3y-EFS: 0.41 vs. 0.60; <jats:inline-formula><i:math xmlns:i=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M5\"><i:mi>P<\/i:mi><i:mo>=<\/i:mo><i:mn>0.02<\/i:mn><\/i:math><\/jats:inline-formula>; HR\u2009=\u20092.6, 95% CI 1.3 to 5.2; 3y-OS: 0.294 vs. 0.59; <jats:inline-formula><k:math xmlns:k=\"http:\/\/www.w3.org\/1998\/Math\/MathML\" id=\"M6\"><k:mi>P<\/k:mi><k:mo>=<\/k:mo><k:mn>0.01<\/k:mn><\/k:math><\/jats:inline-formula>; HR\u2009=\u20092.92, 95% CI 1.29 to 6.6) were revealed as adverse prognostic factors. Conclusion. Young age seems to positively influence patients` survival, especially in patients with primary metastatic disease. In this context, our results support other studies, stating that older age has a negative impact on survival. Tumor volume, metastases, and the type of local therapy modality have an impact on the outcome of sacral EwS. Level of evidence: Level 2. This trial is registered with NCT00020566 and NCT00987636.<\/jats:p>","DOI":"10.1155\/2024\/4751914","type":"journal-article","created":{"date-parts":[[2024,3,16]],"date-time":"2024-03-16T19:05:08Z","timestamp":1710615908000},"page":"1-9","source":"Crossref","is-referenced-by-count":1,"title":["Factors Influencing the Outcome of Patients with Primary Ewing Sarcoma of the Sacrum"],"prefix":"10.1155","volume":"2024","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-2801-7495","authenticated-orcid":true,"given":"Victor","family":"Rechl","sequence":"first","affiliation":[{"name":"Pediatrics III, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4424-7569","authenticated-orcid":true,"given":"Andreas","family":"Ranft","sequence":"additional","affiliation":[{"name":"Pediatrics III, West German Cancer Center, University Hospital Essen, University of Duisburg-Essen, Essen, Germany"},{"name":"German Cancer Consortium, Partnersite, Essen, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9814-2060","authenticated-orcid":true,"given":"Vivek","family":"Bhadri","sequence":"additional","affiliation":[{"name":"Chris O\u2019Brien Lifehouse, Camperdown, Australia"},{"name":"Faculty of Medicine and Health, University of Sydney, Camperdown, Australia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2765-1711","authenticated-orcid":true,"given":"Benedicte","family":"Brichard","sequence":"additional","affiliation":[{"name":"Cliniques Universitaires Saint Luc, Department of Pediatric Hematology and Oncology, Universit\u00e9 Catholique de Louvain, Brussels, Belgium"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4749-1017","authenticated-orcid":true,"given":"Stephane","family":"Collaud","sequence":"additional","affiliation":[{"name":"Lung Clinic, Department of Thoracic Surgery, Cologne Merheim Hospital, University of Witten\/Herdecke, Witten, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0002-7901-8432","authenticated-orcid":true,"given":"Sona","family":"Cyprova","sequence":"additional","affiliation":[{"name":"Charles University, Motol Child Ren\u2019s Hospital, Prague, Czech Republic"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hans","family":"Eich","sequence":"additional","affiliation":[{"name":"Radiotherapy and Radiooncology, University Hospital Muenster, West German Cancer Center Network, Muenster, Germany"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0518-983X","authenticated-orcid":true,"given":"Torben","family":"Ek","sequence":"additional","affiliation":[{"name":"Childhood Cancer Center Queen Silvia Children\u2019s Hospital, Gothenburg, Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9270-8636","authenticated-orcid":true,"given":"Hans","family":"Gelderblom","sequence":"additional","affiliation":[{"name":"Leiden University Medical Center, Department of Medical Oncology, Leiden, NL, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8408-2255","authenticated-orcid":true,"given":"Jendrik","family":"Hardes","sequence":"additional","affiliation":[{"name":"German Cancer Consortium, Partnersite, Essen, Germany"},{"name":"Clinic of Tumororthopedics, University Hospital Essen, West German Cancer Centre, Essen, 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