Ewing Sarcoma of the Spine: Prognostic Variables for Survival and Local Control in Surgically Treated Patients
Bibliographic record
Abstract
Introduction Primary Ewing sarcoma of the spine is a challenging tumor to treat because of a high rate of local recurrence. The optimum role of surgery in the treatment of Ewing sarcoma is not clearly defined. The objective of this study was to analyze factors relevant to survival and local control in surgically treated patients diagnosed with primary Ewing sarcoma of the spine. Materials and Methods A multi-institutional international ambispective with cross-sectional follow-up data was gathered about patients who underwent surgery for primary Ewing sarcoma of the spine. The primary outcomes assessed were 5-year survival and local recurrence. Multiple variables including the Enneking appropriateness of the surgery were evaluated for relationships to the primary outcomes. An Enneking appropriate procedure for Ewing sarcoma is an en bloc resection with negative margins. Survival and recurrence were analyzed using Kaplan–Meier curves and log-rank tests. Results A total of 59 patients diagnosed with primary Ewing sarcoma of the spine underwent surgery. Enneking appropriateness of surgery was known for 55 patients; 30 treated Enneking appropriately (EA) and 25 treated Enneking inappropriately (EI). The 5-year survival was 73% ( n = 22) for EA patients and 48% ( n = 12) for EI patients. Median survival was not achieved within 5-year postoperative for EA patients and was 2.2 years for EI patients ( p = 0.124). Local recurrence occurred in 20% ( n = 6) of patients with an EA procedure versus 48% ( n = 11) of patients with an EI procedure. The rate of local control was favorable for EA-treated patients compared with EI-treated patients ( p = 0.046). Conclusion Primary spinal Ewing sarcoma requires multidisciplinary treatment. An Enneking appropriate surgical procedure is associated with longer survival and better local control. An Enneking appropriate procedure, when feasible, should be the surgical treatment of choice for primary spinal Ewing sarcoma.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".