Survival rates in general are given in medicine as a statistical value of the “5-year survival rate”. This expresses in percent the number of survivors after 5 years in a defined patient group. For Ewing’s sarcoma, the stated survival rate lies in a range between 40% and 60-70%.
These broad ranges result from the fact that the survival rate depends on the infestation of the respective bone region. For example, if bones of the arms and/or legs are affected, the 5-year survival rate is 60-70%. If the pelvic bones are affected, the survival rate is 40%.
How high is the risk of relapse?
The average 5-year survival rate is 50%. Here one can assume that this is an aggressive and malignant cancer. The 5-year survival rate indicates that on average half of all diagnosed Ewing’s sarcoma leads to death. If, however, after 5 years of successful treatment of Ewing sarcoma no further findings can be detected, the cancer is said to be cured.
- In year 1 and 2:should be a clinical examination every three months. This will usually include a local X-ray checkup, laboratory tests, a CT of the thorax and a full-body skeletal scintigraphy. Once every six months, a local MRI is usually performed.
- In the year 3 to 5:a clinical examination should be performed at six-month intervals. During this examination, a local X-ray checkup, laboratory tests, a CT of the thorax and a whole-body skeletal scintigraphy are usually performed. Once a year a local MRI is usually performed. – From year 6 onwards, the following is usually performed once a year: an X-ray control with laboratory examination and a CT of the thorax as well as a whole-body skeletal scintigraphy and a local MRI.
The disease (Ewing’s sarcoma) got its name from the first description by James Ewing in 1921: highly malignant tumours that develop from degenerated primitive neuroectodermal cells (= immature precursor cells of nerve cells). Thus Ewing sarcomas belong to the primitive, malignant, solid tumors. As already mentioned above, Ewing’s sarcomas mainly affect the middle areas of the long tubular bones and the pelvis, but it is also possible that the upper arm (= humerus) or the ribs are affected, so that parallel to the osteosarcoma appear.
Due to the accompanying signs of inflammation, confusion with osteomyelitis is conceivable. Due to metastases, which occur very quickly (approx. 1⁄4 of all patients already show so-called daughter metastases at diagnosis), Ewing sarcomas can be found in soft tissue similar to rhabdomyosarcoma.
The lungs are usually the most affected by metastasis. The causes that could be responsible for the development of Ewing sarcoma are still unknown. However, it is currently assumed that neither the genetic component (heredity) nor an already performed radiotherapy can be held responsible for the development.
It has been found, however, that Ewing’s sarcoma often occurs when there are skeletal anomalies in the family or when patients suffer from retinoblastoma (= malignant retinal tumour occurring in adolescence) from birth. Research has shown that tumour cells of the so-called family of Ewing’s sarcoma show a change on chromosome no. 22.
It is assumed that this mutation (genetic change) is present in about 95% of all patients. Ewing sarcomas can cause swelling and pain in the affected region(s), which may also be associated with functional limitations. Fever and moderate leukocytosis (= increase in the number of leukocytes in the blood) are also conceivable.
Due to the possibility of confusion with, for example, osteomyelites (see above), a diagnosis is not always easy and may therefore require a biopsy (=fine tissue examination of a tissue sample) in addition to the imaging procedures (X-ray examination). Therapeutic approaches are usually applied on several levels. On the one hand, the so-called therapy plan preoperatively usually provides for chemotherapeutic treatment (= neoadjuvant chemotherapy).
Even after the surgical removal of the Ewing sarcoma, the patient is treated therapeutically by radiation therapy and, if necessary, renewed chemotherapy. This is where a difference to osteosarcoma becomes noticeable: Compared to the Ewing sarcoma, the osteosarcoma has a lower radiation sensitivity. Whether recurrences (renewed tumour growth) occur depends strongly on the extent of metastasis formation, the response to preoperative chemotherapy and the “radicality” of the tumour removal. It is currently assumed that the five-year survival probability is about 50%. In particular, surgical improvements over the last 25 years have made it possible to improve the probability of survival