TriangleHEALTH PROFESSIONAL · SOURCE READING
Surgery
Source: Ewing Sarcoma and Undifferentiated Small Round Cell Sarcomas of Bone and Soft Tissue Treatment (PDQ®)–Health Professional Version, National Cancer Institute.
Source updated: November 27, 2024 · Captured 2026-09-09.
Selected source text with whitespace normalised. This Triangle page is not an NCI PDQ summary.
Context: Treatment of Localized Ewing Sarcoma / Local-Control Measures
Surgery is generally the preferred approach if the lesion is resectable.[18,19] The superiority of resection for local control has never been tested in a prospective randomized trial. The apparent superiority may represent selection bias.
In past studies, smaller, more peripheral tumors were more likely to be treated with surgery, and larger, more central tumors were more likely to be treated with radiation therapy.[20]
Source links and citations
An Italian retrospective study showed that surgery improved outcome only in extremity tumors, although the number of patients with central axis Ewing sarcoma who achieved adequate margins was small.[8]
Source links and citations
In a series of 39 patients who received both surgery and radiation therapy at St. Jude Children's Research Hospital, the 8-year local failure rate was 5% for patients with negative surgical margins and 17% for those with positive margins.[5]
Source links and citations
Data for patients with pelvic primary Ewing sarcoma from a North American intergroup trial showed no difference in local control or survival based on local-control modality—surgery alone, radiation therapy alone, or radiation plus surgery.[21]
Source links and citations
Patients with residual viable tumor in the resected specimen have a worse outcome than those with complete necrosis. In a French Ewing sarcoma study (EW88), the EFS rates were 75% for patients with less than 5% viable tumor, 48% for patients with 5% to 30% viable tumor, and 20% for patients with more than 30% viable tumor.[20]
Source links and citations
A single-institution retrospective analysis of 78 patients with Ewing sarcoma suggested that pathological fracture at initial presentation was associated with inferior EFS and OS.[22][Level of evidence C1] Another study found that pathological fracture at the time of diagnosis did not preclude surgical resection and was not associated with adverse outcome.[23]
Source links and citations
Publication references
Read the original reference and check its publication notices.
Preserved source evidence · Not medical advice