Prognosis and survival for childhood Ewing sarcoma of the bone

Last medical review:

The following are prognostic and predictive factors for childhood Ewing sarcoma of the bone.

If the cancer has spread

Metastasis is when cancer spreads from where it started to another part of the body. Whether or not the cancer has already spread when it is first diagnosed is one of the most important prognostic factors for childhood Ewing sarcoma of the bone. Metastasis is linked with a poorer prognosis.

Ewing sarcoma that has only spread to a lung has a more favourable prognosis than Ewing sarcoma with metastasis to other parts of the body. In general, the more sites of disease there are, the worse the prognosis.

Location of the tumour

Ewing sarcoma that is found further from the centre of the body has a better prognosis. For example, Ewing sarcoma in the arm or leg has a better prognosis than Ewing sarcoma in the pelvis.

Tumour size

Smaller tumours tend to have a better prognosis.


Younger children have a better prognosis than children who are 15 or older.

Lactate dehydrogenase (LDH) level

Children with a normal level of lactate dehydrogenase (LDH) in the blood have a more favourable prognosis than those with higher LDH levels.

Broken bones

Tumours that cause breaks (fractures) in the bone have a poorer prognosis than tumours that have not led to broken bones.

Response to neoadjuvant chemotherapy

Chemotherapy is usually given before surgery to shrink the tumour and make surgery easier. This is called neoadjuvant chemotherapy. Ewing sarcoma that has a poor response to neoadjuvant chemotherapy has an increased risk of recurring (coming back).

Expert review and references

  • Abha Gupta, MD, MSc, FRCPC
  • Raveena Ramphal, MBChB, FRACP

Survival statistics for childhood Ewing sarcoma of the bone

Survival statistics for Ewing sarcoma (a type of childhood bone cancer) are very general estimates and must be interpreted very carefully.