Do repeated surgical interventions in patients with lumbar paraspinal Ewing's sarcoma increase survival by supporting pharmacological treatment? A comprehensive systematic review

Abstract

Aim: To present the medical and surgical treatment of a patient who was diagnosed with Ewing's sarcoma (EWS) in the paraspinal region and was operated on, in line with a comprehensive systematic literature review.

Method: A comprehensive and systematic literature search of electronic databases was performed. Keywords used were “EWS” and “EWS treatment”. Randomized, controlled clinical trials were included in the study. Letters to the editor, bibliographies, reviews, and meta-analyses were excluded. In addition, our EWS case was presented in full detail.

Results As a results of a comprehensive and systematic literature search of electronic databases, the full texts of the appropriate 323 studies conducted between the years 1786 to 2021 were retrieved and evaluated. In the case we present here, the expandable mass was largely excised together with the invasive skin tissue. Immunohistochemical examination of the excised tumor tissue using vimentin antibody revealed that the mass was compatible with EWS, a mesenchymal malignant tumor.

Conclusion: Many different pharmacological agents can be administered in different posologies and different combinations before and after paraspinal/paravertebral lumbar surgery of EWS.  Further studies containing more cases from different races, gender must be performed to comprehensively evaluate the effects of repeated surgical interventions of patients with EWS  due to recurrence and/or residue, which may positively contribute to patient's survival and prognosis by giving more time to standard chemotherapy.