Outcome of multidisciplinary treatment of peripheral primitive neuroectodermal tumor

Abstract

Peripheral primitive neuroectodermal tumors (PNETs) constitute very rare and aggressive malignancies. To date, there are no standard guidelines for management of peripheral PNETs due to the paucity of cases arising in various body sites. Therapeutic approach is derived from Ewing sarcoma family, which currently remains multimodal. Our study retrospectively analyzed 86 PNET patients from February 1, 1998 to February 1, 2018 at Peking Union Medical College Hospital with an additional 75 patients from review of literature. The clinicopathologic and treatment plans associated with survival was investigated. Surgery, chemotherapy, female sex, small tumor size, no lymph node metastasis, R0 surgical resection, (vincristine + doxorubicin + cyclophosphamide)/(isophosphamide + etoposide) regimen, and more than 10 cycles of chemotherapy were associated with improved overall survival in univariate analysis. Surgery, more than 10 cycles of chemotherapy, and small tumor size were independent prognostic factors for higher overall survival. Our data indicates that multimodal therapy is the mainstay therapeutic approach for peripheral PNET.

Figure 1

Flowchart of studies included in the analysis. 1142 articles were initially identified from Pubmed database, and 53 were finally included in the current analysis.

Figure 2

Overall survival and progression free survival of the entire cohort. The 5-year, 3-year, 1-year overall survival rates were 54%, 60%, and 81%, respectively. The 5-year, 3-year, 1-year progression free survival rates were 38%, 44%, and 59%, respectively.