Adenam, Norhaila Mohamad
(2016)
Survival rate and prognostic factors of Ewing Family Tumor in paediatric patients (a 11-year review) in Hospital USM from 2002-2012.
Masters thesis, Universiti Sains Malaysia.
Abstract
Introduction
Ewing Family Tumor (EFT) is a very malignant and aggressive tumor. It was very rare
tumor especially in Asia compare to western countries. During the past three decades, the
prognosis of patient with EFT had improves considerably as shown in several clinical
trials, mainly because of improved chemotherapy regimes. In our country, there is lack of
reports in the treatment outcome and survival of children with EFT. There is no published
study predicting the treatment outcome in Hospital USM at present.
Objectives
The objectives of this study were to evaluate the Overall Survival (OS) and Event Free
Survival (EFS) rate of patients who were diagnosed with EFT. We want to evaluate the
demographic data and identify the possible predictive factors that determine the EFS and
OS rate of those children with EFT and treated in Hospital USM.
Methodology
This is a retrospective record review of children aged 0-18 years with EFT. Children were
identified from registration data in Oncology Unit and medical records from Record Office
HUSM. In case of uncontactable or deceased patients, a letter was sent to State Registry to
obtain the end result/outcome of the patients. The associations of demographic and clinical
factors with patients outcome were determined by Cox regression. Survival curves were
estimated by the Kaplan-Meier method and compared by the Log-rank test.
Results
There were 51 patients identified from the registration but then only 29 children were
enrolled in this study, which full filled all the inclusion criteria.
The mean duration follow up was 21 months. The OS rate at 1, 2, 3 and 5 years were
62.1%, 44.8%, 30.2% and 21.6% respectively. The EFS rate at 1, 2, 3 and 5 years were
41.9%, 26.7%, 17.8% and 0% respectively.
Multivariate Cox regression analysis showed that presence of surgical intervention
(p=0.030) and major complications (p=0.045) were significant prognostic factors to the
survival of EFT in this study.
Conclusion
Survival rate among our patients was comparable to other developing countries. However
we are far away if compared to developed countries as the survival rate only achieved
almost half from their survival rate. We are able to identify two significant independent
prognostic factors to the survival for EFT in our patients which were surgical intervention
and presence of major complications.
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