Treatment patterns and survival outcomes of Ewing sarcoma in Ethiopia: A five-year retrospective analysis from a tertiary hospital

Abstract Background : Ewing sarcoma is a malignant small round-cell sarcoma of bone or soft tissue that is highly responsive to modern multimodal therapy and considered as highly curable disease developed countries. However, survival remains poor in developing countries.This study aims to assess treatment patterns and survival outcomes of Ewing sarcoma at Tikur Anbessa Hospital. Methods and Materials : we conducted a retrospective study on all patient diagnosed with Ewing sarcoma at Tikur Anbessa Hospital between November 15, 2018, and November 15, 2023. Descriptive statistics and Kaplan-Meier survival analysis were used to analyze the data. Result : The median age at diagnosis was 19 years, with most of the patients (67.2%) in the age range of 8-25 year. The main modality of treatment for localized disease was chemotherapy combined with surgery, whereas chemotherapy alone was used for metastatic disease. The 3-year overall survival (OS) and event-free survival (EFS) for entire cohort were 68%% and 40%, respectively. The 3-year OS and EFS rates were 89% and 76% for localized disease versus 10% and 0% for metastatic disease.This diffrence for both OS and EFS reaching statistical significance (log-rank p < 0.001). Small tumor size (≤ 8 cm), surgical intervention and localized stage were associated with statistically significant improvement in OS and EFS, whereas pelvic location was poorer prognosis. Conclusion : Ewing sarcoma at our institution mainly affects adolescents and young adults. Survival is poor, especially for metastatic disease, while localized tumors, smaller size, and surgery are associated with better survival. Theirfor early diagnosis and improved multimodal treatment are needed to improve survival.