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Site of Relapse in Children with Metastatic Ewing Sarcoma

Ewing sarcoma occurs most commonly in adolescents and young adults. Metastatic disease occurs in approximately 25% of patients, most commonly in the lungs, and is associated with poor overall prognosis. Multimodal therapy, including chemotherapy, radiation and/or surgery is typically used to treat the primary tumor. Because the tumor is chemo- and radio-sensitive, the standard therapy for pulmonary metastatic disease is non-surgical. However recurrence is common and new treatment modalities are needed. Pulmonary metastasectomy, utilized routinely for other tumor types, could be helpful if (a) pulmonary relapse were more common in patients who have residual nodules seen on CT after initial chemotherapy and radiation or (b) if pulmonary relapse occurs commonly at sites of initial (pre-treatment) disease. This retrospective study is investigating these two questions, to inform future prospective studies on the role of pulmonary metastasectomy in this disease.


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