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Adolescent & Young Adult Sarcomas

(P 09) A NOMOGRAM MODEL TO PREDICT THE OVERALL SURVIVAL OF ADOLESCENT AND YOUNG ADULT PATIENTS WITH LOCALLY ADVANCED EWING SARCOMA.

Location: The Liffey, Level 1

    Author(s)

  • Paulina Jagodzińska-Mucha

    doctor
    Department of Soft Tissue, Bone/Sarcoma, and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
    Warsaw, Mazowieckie, Poland

    • Co-Author(s)

  • SK

    Sylwia Kopeć, n/a

    Department of Soft Tissue, Bone/Sarcoma, and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
    Warsaw, Mazowieckie, Poland

  • MR

    Magdalena Rosińska, n/a

    Department of Computational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
    Warsaw, Mazowieckie, Poland

  • Pawel Sobczuk, MD PhD (he/him/his)

    Fellow
    Maria Sklodowska-Curie National Research Institute of Oncology
    Warsaw, Mazowieckie, Poland

  • Katarzyna Kozak, MD, PhD

    medical oncologist
    Maria Sklodowska-Curie National Research Institute of Oncology Warsaw Poland
    Warsaw, Mazowieckie, Poland

  • PT

    Paweł Teterycz, n/a

    Department of Soft Tissue, Bone/Sarcoma, and Melanoma, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland. Department of Computational Oncology, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
    Warsaw, Mazowieckie, Poland

  • I

    Iwona Ługowska, n/a

    Early Phase Clinical Trials Unit, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
    Warsaw, Mazowieckie, Poland

  • Ar

    Anna raciborska, n/a

    Department of Oncology and Surgical Oncology for Children and Youth, Mother and Child Institute, 01-211 Warsaw, Poland.
    Warsaw, Mazowieckie, Poland

  • KB

    Katarzyna Bilska, n/a

    Department of Oncology and Surgical Oncology for Children and Youth, Mother and Child Institute, 01-211 Warsaw, Poland.
    Warsaw, Mazowieckie, Poland

  • MW

    Michał Wągrodzki, n/a

    Department of Pathology and Laboratory Diagnostics, Maria Sklodowska-Curie National Research Institute of Oncology, 02-781 Warsaw, Poland.
    Warsaw, Mazowieckie, Poland

  • Piotr Rutkowski, MD, PhD

    Head of Department of Soft Tissue/Bone Sarcoma and Melanoma
    Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw, Department of Soft Tissue/Bone Sarcoma and Melanoma
    Warsaw, Mazowieckie, Poland

Objective: There are several well-known prognostic factors for Ewing sarcoma (ES) patients, but so far they have not been implemented in decision-making in clinical practice. We aimed to construct a prognostic model for overall survival after the completion of the curative treatment in patients with locally advanced ES.

Methods: We extracted data on 256 nonmetastatic patients ≤25 years of age, treated between 1998 and 2018 at Mother and Child Institute, Warsaw (n=192) and Maria Sklodowska-Curie National Research Institute of Oncology in Warsaw (n=64). raining set (n=188) was used to identify independent prognostic factors for overall survival (OS) with the Kaplan-Meier estimator, log-rank test, and the multivariate Cox model. Identified factors were used to construct the nomogram, which was validated in the validation set (n=65).

Results: The results of multivariate Cox regression used to create the nomogram showed that age, pathologic fracture, type of induction chemotherapy (VIDE vs other), type of local treatment (radiotherapy+ surgery vs surgery vs radiotherapy), and the time of diagnosis were independent prognostic factors.
Pathological fracture (HR 4.62, 95% CI 1.81 – 11.80), and no local treatment (6.10, 95%CI 1.93 – 19.30) are negative prognostic factors. The prognosis improved significantly with the time of diagnosis, by 8% per year (HR 0.92, 95% CI 0.87-0.97). Age 10 years or less at diagnosis and receiving VIDE as an induction therapy regimen tended to predict better OS. Model calibration assessment showed that the nomogram has a good agreement for the patient’s survival at selected time points (24 and 60 months). The Harrell’s concordance index on the training dataset was 0.78 (95%CI 0.72 - 0.84) and on the validation dataset i0.69 (95% CI 0.56 – 0.83).

Conclusion: Our nomogram has predictive power and could be helpful to assess the risk among ES patients and guide treatment decisions; however, it should be further validated in external datasets.