(P 451) IMPACT OF TIME TO DIAGNOSIS - A PROSPECTIVE ANALYSIS OF THE EWING 2008 TRIAL

Location: The Liffey, Level 1

Author(s)

Josephine Kersting, MD (she/her/hers)

Medical Doctor
Pediatrics III, University Hospital Essen, West German Cancer Center
Duesseldorf, Nordrhein-Westfalen, Germany

Co-Author(s)

AR

Andreas Ranft, N/A, Dr.

University Hospital Essen
Essen, Nordrhein-Westfalen, Germany
Vivek A. Bhadri, MD, PhD (he/him/his)

Medical Oncologist
Chris O'Brien Lifehouse
Sydney, New South Wales, Australia
BB

Bénédicte Brichard, MD

Cliniques Universitaires Saint Luc
Brussels, Brussels Hoofdstedelijk Gewest, Belgium
SC

Stéphane Collaud, MD

Head of the Dept. of Thoracic Surgery
Cologne Merheim Hospital
Köln, Nordrhein-Westfalen, Germany
SC

Sona Cyprovà, MD

Motol Children's Hospital
Prague, Hlavni mesto Praha, Czech Republic
HE

Hans Eich, MD

University Hospital Münster
Münster, Nordrhein-Westfalen, Germany
Torben Ek, PhD, MD

Senior Consultant
University of Gothenburg
Gothenburg, Vastra Gotaland, Sweden
Hans Gelderblom, MD, PhD (he/him/his)

Medical Oncologist
Leiden University Medical Center
Leiden, Zuid-Holland, Netherlands
JH

Jendrik Hardes, MD

University Hospital Essen
Essen, Nordrhein-Westfalen, Germany
LH

Lianne M. Haveman, MD, PhD

Paediatric Oncologist
Princess Máxima Center for Pediatric Oncology
Utrecht, Utrecht, Netherlands
WH

Wolfgang Hartmann, N/A, MD

University Hospital Münster
Münster, Nordrhein-Westfalen, Germany
PH

Peter Hauser, PhD, MD

Associate professor
Semmelweis University
Budapest, Budapest, Hungary
HJ

Heribert Jürgens, MD

University Hospital Münster
Münster, Nordrhein-Westfalen, Germany
Jukka Kanerva, MD, PhD

Consultant
HUS Helsinki University Hospital, New Children’s Hospital, Finland
Helsinki, Uusimaa, Finland
Thomas Kühne, MD

Acting Head
University Children's Hospital Basel
Basel, Basel-Stadt, Switzerland
AR

Anna Raciborska, MD

Insitute of Mother and Child
Warsow, Mazowieckie, Poland
JR

Jelena Rascon, PhD, MD

Vilnius University Hospital
Vilnius, Vilniaus Apskritis, Lithuania
AS

Arne Streitbürger, MD

University Hospital Essen
Essen, Nordrhein-Westfalen, Germany
Beate Timmermann, MD (she/her/hers)

Director of the Clinic of Particle Therapy, Medical head of West German Proton Therapy Centre Essen (WPE)
University Hospital Essen
Essen, Nordrhein-Westfalen, Germany
Yasmin Uhlenbruch, MD

St. Josef's Hospital Bochum
Bochum, Nordrhein-Westfalen, Germany

Co-Author(s)

WG

Wiebke K. Guder, MD

Department of Orthopedic Oncology, University Hospital Essen
Essen, Nordrhein-Westfalen, Germany
Maximilian Kerkhoff, MSc (he/him/his)

PhD student
Pediatrics III, University Hospital Essen, West German Cancer Center
Essen, Nordrhein-Westfalen, Germany

Co-Author(s)

Uta Dirksen, MD

Professor
University Hospital Essen, Pediatrics III, West German Cancer Center, German Cancer Research Center (DKTK) site Essen, National Center for Tumordiseases (NCT) site Essen, ,
Essen, Nordrhein-Westfalen, Germany

Objective: Time to diagnosis (TtD) is defined as the time in days between the first symptom and the date of diagnosis. For Ewing Sarcoma (EwS) it has been reported to be amongst the longest in paediatric cancers. Results of previous studies seem to not show an association between time and outcome. Impact on time-to diagnosis on outcome was a secondary objective in the Ewing 2008 trial (NCT00987636).

Methods: A total of 1411 patients were enrolled into the Ewing 2008 trial and were therefore treated with the same treatment protocol. Information on patient-reported date and type of first symptom, including pain, pathological fracture and swelling, were prospectively gathered at time of diagnosis.

Results: TtD was calculated for 1265 patients. Median TtD was 82 days (IQR 31-180 days). TtD was longer for patients older than 15 years of age and pelvic tumours (p>.001). Univariable analysis revealed a HR 1.41 (p=.003) between time and EFS at a cut-off of 31 days. In localized and metastatic disease HR in univariable regression analysis were 1.22 (p=.22) and 1.48 (p=.02), respectively. Multivariable regression analysis revealed HR of 1.30 (p=.03) for time. Subgroup multivariable analysis for metastatic disease revealed HR=1.59 (p=.01) for time.

Conclusion: Results of this analysis demonstrate an association between longer TtD and outcome at a cut-off of 31 days. This effect was particularly strong in metastatic disease.