Surgery for Ewing Sarcoma: What You Should Know

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The aim of surgery for Ewing sarcoma is to remove as much tumor as possible while preserving function and mobility. Surgery is combined with chemotherapy and sometimes radiation therapy.
Ewing sarcoma is a type of cancer that starts in bones and soft tissues. It’s rare and primarily affects children and younger adults. It affects about 1.7 in 1 million children under 15 years old.
Treatment for Ewing sarcoma usually involves surgery, which helps remove the tumor from your body. Surgery is typically used along with chemotherapy. Radiation treatment may also be used when surgery cannot remove the whole tumor.
Here, we’ll take a closer look at surgery for Ewing sarcoma, including the different types of surgery, what the surgery involves, its success rates, and what recovery from surgery looks like.

What is the surgery for Ewing sarcoma?

What is the surgery for Ewing sarcoma?
The kind of surgery required to treat Ewing sarcoma is determined by:
the tumor’s size
the tumor’s location
your overall health status
how well surgery will be able to remove the cancer
other treatments you’re receiving
how the surgery will affect your future mobility and function
The goal of surgery is to remove as much of the cancer as possible while ensuring that the affected part of your body will continue to function. Most of the time, if the tumors are in soft tissues or in areas such as your arms or legs, surgery is less complicated.
For tumors in your arms or legs, doctors may consider two types of surgery:
limb-sparing surgery, in which surgeons remove the tumor while ensuring that the limb remains efficient
amputation, which is used when removing the entire limb is the only way to successfully remove the tumor or to ensure that it doesn’t come back
For tumors in your spine, pelvis, skull, or chest wall, surgery is more complicated, and it might not be possible to remove the entire tumor this way. In these cases, radiation therapy may be necessary to fully remove the cancer.

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How common is surgery for Ewing sarcoma?

How common is surgery for Ewing sarcoma?
Although it’s not used in every case, surgery is a common treatment for Ewing sarcoma.
The current standard of care for Ewing sarcoma involves a multidisciplinary approach, including:
surgery
chemotherapy
radiation therapy
Typically, chemotherapy is the first-line treatment for Ewing sarcoma.
Once chemotherapy is complete, doctors can determine whether surgery or radiation therapy is the best treatment for any remaining cancer. In most cases, they will consider surgery first. If they determine that they cannot successfully remove the tumor with surgery, they will use radiation therapy instead.
Although surgery, chemotherapy, and radiation therapy are the most commonly used treatments for Ewing sarcoma, they are not the latest treatments available. There are always new treatments in clinical trials for Ewing sarcoma. It’s possible that these treatments will one day become the foundation of treatment for the condition.

What’s involved in this surgery for tumor removal?

What’s involved in this surgery for tumor removal?
Surgery for Ewing sarcoma is complex. The timing and procedure are unique to each individual.
If tumors are located in your arms or legs, a surgeon will aim to preserve as much function as possible and avoid amputation whenever possible. Surgery often involves using artificial joints or bone grafts to reconstruct any bones, joints, or tissues that are removed during the surgery.
Surgery for tumors in other locations (such as your chest wall or pelvis) may involve similar methods, and surgeons will usually replace any missing bones or joints with human-made materials. When amputation is necessary, surgeons may implant a prosthesis into the remaining part of the limb to allow for easier attachment of an external prosthetic limb.

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What is the survival rate for Ewing sarcoma with surgery?

What is the survival rate for Ewing sarcoma with surgery?
Surgery alone doesn’t offer the best survival rates for Ewing sarcoma. Before chemotherapy was combined with surgery and radiation therapy, the long-term survival rate for Ewing sarcoma was less than 10%.
Now that the standard of care involves surgery, radiation therapy, and chemotherapy, survival rates are much higher. The 5-year survival rate is 37–60% in people with metastatic Ewing sarcoma (meaning that the cancer has spread beyond the initial tumor). People whose cancer has not spread have a 5-year survival rate of 49–60%.
Your survival rate will depend on many factors, including your age, your sex, how much the tumor has spread, and how much of the tumor can be removed through surgery or other treatment methods.

How long does recovery from this surgery take?

How long does recovery from this surgery take?
Rehabilitation, which includes physical and occupational therapy, is vital after surgery for Ewing sarcoma. The length of recovery time will depend on which body part is affected and what the surgery involves.
According to the American Cancer Society, if you have limb-sparing surgery, recovery usually takes about a year. If you have an amputation, recovery (including learning how to walk with your new limb) takes 3–6 months.

What are newer treatments for Ewing sarcoma that are not surgery?

What are newer treatments for Ewing sarcoma that are not surgery?
Several types of treatment for Ewing sarcoma that don’t involve surgery are currently in clinical trials. However, many of these are meant to be used in conjunction with surgery. Your doctor will help you determine the best course of treatment if you choose to try a treatment that’s still in clinical trials.
Newer treatments for Ewing sarcoma include:
targeted therapy, which uses medication or other substances to destroy specific cancer cells
immunotherapy or biological therapy, which uses your own immune system to attack your cancer
CAR T-cell therapy, which transforms T cells in your body so that they can fight cancer

Takeaway

Takeaway
Surgery is one of the standard treatments for Ewing sarcoma. Surgery usually takes place after a course of chemotherapy, and its main goal is to remove as much of the tumor as possible. During the procedure, surgeons often need to reconstruct any bones, joints, or soft tissues that they remove along with the tumor.
Each case of Ewing sarcoma requires an individualized approach to treatment. While surgery may be part of the picture for you, it’s not used in every case. Talk with your care team to learn more about your treatment plan.

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