Ewing sarcoma

Stages describe how far Ewing sarcoma has spread. They help the healthcare team plan treatment. Healthcare professionals most often describe the stage of Ewing sarcoma as localized or metastatic:

• Localized Ewing sarcoma. The cancer has not spread to a distant part of the body. It's limited to the area where it started or in surrounding tissues such as muscles or tendons.
• Metastatic Ewing sarcoma. The cancer has spread from where it started to another part of the body. The most common sites of spread are the lungs, other bones or the bone marrow.

Though treatment discussions for Ewing sarcoma usually focus on whether the cancer is localized or metastatic, the American Joint Committee on Cancer (AJCC) uses tumor, nodes and metastasis (TNM) staging for bone sarcoma. The TNM staging takes into account the tumor grade, location, size, and whether the cancer has spread to lymph nodes or other parts of the body. AJCC TNM staging is used less often for Ewing sarcoma.

To find out whether Ewing sarcoma has spread, the healthcare team uses imaging such as MRI, a CT scan, a PET scan and sometimes a bone scan. A biopsy removes a sample of the tumor for testing. The biopsy can confirm the diagnosis of Ewing sarcoma.

Whether cancer has spread is one of the most important factors that affects the outlook, also called the prognosis.

Treatment usually includes chemotherapy and surgery. Sometimes radiation therapy is used before or after surgery, or instead of surgery.