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Skeletal Radiology

07-05-2024 | Sarcoma | Scientific Article

A reduction in tumor volume exceeding 65% predicts a good histological response to neoadjuvant chemotherapy in patients with Ewing sarcoma

Authors: Ayano Aso, Hisaki Aiba, Matteo Traversari, Alberto Righi, Marco Gambarotti, Ahmed Atherley O’Meally, Konstantina Solou, Silvia Cammelli, Barbara Bordini, Monica Cosentino, Federica Zuccheri, Barbara Dozza, Giorgio Frega, Toni Ibrahim, Marco Manfrini, Davide Maria Donati, Costantino Errani

Published in: Skeletal Radiology

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Abstract

Objective

No consensus exists for tumor volume response criteria in patients with Ewing sarcoma. This study aimed to identify an optimal cutoff for predicting a good histological response by analyzing tumor volume changes and tumor necrosis after neoadjuvant chemotherapy.

Materials and methods

We performed a retrospective analysis of 184 Ewing sarcoma patients, analyzing tumor volume changes before and after neoadjuvant chemotherapy. Patients were divided into two groups based on histological response: good (tumor necrosis ≥ 95%) and poor (tumor necrosis < 95%) responders. The receiver operating characteristic (ROC) area under the curve (AUC) method was used to determine the optimal thresholds for predicting the histological response. Additionally, the prognostic value of this cutoff for relapse-free survival was assessed.

Results

Out of 184 patients, 83 (45%) had tumor necrosis ≥ 95%, while 101 (55%) had tumor necrosis < 95%. ROC analysis identified the optimal cutoff for a good histological response as over 65% tumor volume reduction (AUC = 0.69; p < 0.001). Patients with volume reduction of ≥ 65% had a higher likelihood of a good histological response than those with lesser reductions (p = 0.004; odds ratio = 2.61). Multivariable analysis indicated a correlation between poor histological response and reduced relapse-free survival (hazard ratio = 2.17; p = 0.01), while tumor volume reduction itself did not impact survival.

Conclusion

We reported that a tumor volume reduction of ≥ 65% was able to predict a good histological response in Ewing sarcoma patients. We recommend preoperative tumor volume assessment to identify patients at greater risk for poor histological response who could benefit from more intensive chemotherapy protocols or additional radiotherapy.
Appendix
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Metadata
Title
A reduction in tumor volume exceeding 65% predicts a good histological response to neoadjuvant chemotherapy in patients with Ewing sarcoma
Authors
Ayano Aso
Hisaki Aiba
Matteo Traversari
Alberto Righi
Marco Gambarotti
Ahmed Atherley O’Meally
Konstantina Solou
Silvia Cammelli
Barbara Bordini
Monica Cosentino
Federica Zuccheri
Barbara Dozza
Giorgio Frega
Toni Ibrahim
Marco Manfrini
Davide Maria Donati
Costantino Errani
Publication date
07-05-2024
Publisher
Springer Berlin Heidelberg
Published in
Skeletal Radiology
Print ISSN: 0364-2348
Electronic ISSN: 1432-2161
DOI
https://doi.org/10.1007/s00256-024-04702-7