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Role of Bone Marrow Biopsy for Staging New Patients with Ewing Sarcoma: A Systematic Review
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  • Kevin Campbell,
  • David Shulman,
  • Holcombe Grier,
  • Steven DuBois
Kevin Campbell
Children's Hospital Boston
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David Shulman
Boston Children's Hospital
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Holcombe Grier
Dana Farber Cancer Institute
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Steven DuBois
Dana-Farber Cancer Institute
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Abstract

The incidence of bone marrow metastasis (BMM) in newly diagnosed Ewing sarcoma (ES) is variable across studies. An optimal staging strategy for detecting BMM is not defined. While BM biopsy and/or aspirate (BMBA) have been the gold standard, [F-18]fluorodeoxyglucose positron emission tomography (FDG-PET) to detect BM metastasis may decrease reliance on BMBA. We conducted a systematic review to assess incidence of BMM and the role of FDG-PET. We observed a pooled incidence by BMBA of BMM of 4.8% in all newly diagnosed ES patients and 17.5% among patients with metastatic disease. Only 1.2% of patients had BMM as their sole metastatic site. FDG-PET detection of BMM compared to BMBA demonstrated pooled 100% sensitivity and 96% specificity, positive predictive value of 75% and negative predictive value of 100%. In the era of FDG-PET imaging, omission of BMBA may be considered in patients with otherwise localized disease after initial staging studies.

Peer review status:Published

16 Sep 2020Submitted to Pediatric Blood & Cancer
16 Sep 2020Submission Checks Completed
16 Sep 2020Assigned to Editor
22 Sep 2020Reviewer(s) Assigned
05 Oct 2020Review(s) Completed, Editorial Evaluation Pending
10 Oct 2020Editorial Decision: Revise Minor
19 Oct 20201st Revision Received
19 Oct 2020Submission Checks Completed
19 Oct 2020Assigned to Editor
21 Oct 2020Reviewer(s) Assigned
23 Oct 2020Review(s) Completed, Editorial Evaluation Pending
28 Oct 2020Editorial Decision: Accept
21 Nov 2020Published in Pediatric Blood & Cancer. 10.1002/pbc.28807