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Is It Time to Call Time on Bone Marrow Biopsy for Staging Ewing Sarcoma (ES)?

Ingley, KM; Wan, S; Vöö, S; Windsor, R; Michelagnoli, M; Saifuddin, A; Strauss, SJ; (2021) Is It Time to Call Time on Bone Marrow Biopsy for Staging Ewing Sarcoma (ES)? Cancers , 13 (13) , Article 3261. 10.3390/cancers13133261. Green open access

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Abstract

Primary malignant bone sarcomas are rare and Ewing sarcoma (ES), along with osteosarcoma, predominates in teenagers and young adults. The well-established multimodality treatment incorporates systemic chemotherapy with local control in the form of surgery, with or without radiation. The presence and extent of metastases at diagnosis remains the most important prognostic factor in determining patient outcome; patients with skeletal metastases or bone marrow infiltration having a significantly worse outcome than those with lung metastases alone. There is, however, no accepted staging algorithm for ES. Large cooperative groups and national guidelines continue to advocate bone marrow biopsy (BMB) for staging but functional imaging techniques, such as 18F-fluorodeoxyglucose positron emission tomography (FDG-PET) with computerised tomography (CT) have been increasingly used for staging cancers and whole-body magnetic resonance imaging (WB-MRI) for staging skeletal metastases. This review outlines the current literature, from which we conclude that BMB is no longer required for the staging of ES as it does not influence the standard of care management. BMB may, however, provide prognostic information and insights into the biology of ES in selected patients on prospective clinical trials.

Type: Article
Title: Is It Time to Call Time on Bone Marrow Biopsy for Staging Ewing Sarcoma (ES)?
Location: Switzerland
Open access status: An open access version is available from UCL Discovery
DOI: 10.3390/cancers13133261
Publisher version: http://dx.doi.org/10.3390/cancers13133261
Language: English
Additional information: This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited
Keywords: 18F-fluorodeoxyglucose (18FDG), Ewing sarcoma, bone marrow biopsy, bone scintigraphy, bone/bone marrow metastases, functional imaging, positron emission tomography/computed tomography (PET/CT), staging, whole body magnetic resonance imaging (WB-MRI)
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Medical Sciences > Cancer Institute > Research Department of Oncology
URI: https://discovery.ucl.ac.uk/id/eprint/10130756
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