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Das Ewing-Sarkom in der Literatur: Kritische Studien zur histomorphologischen Definition und zur Prognose

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Archiv für orthopädische und Unfall-Chirurgie, mit besonderer Berücksichtigung der Frakturenlehre und der orthopädisch-chirurgischen Technik Aims and scope Submit manuscript

Summary

Studying the literature which has been published since 1938 about Ewing's Sarcoma, one may find the most different statements concerning the 5 year survivalrates. The reason for the various judgement of the tumor's prognosis is to be seen in differences in the histological diagnosis. The possible sources for mistakes in the morphological description of Ewings Sarcoma are shown, calling special attention to the negative result of reticular fibre staining and the positive glycogen-test. The basis for the critique of too high survivalrates is the absence of some of those histological criteria which are absolutely necessary for the identification of Ewing's Sarcoma.

Basing one's judgement on the severe standard, one sees that hardly one statistic or casuistic has regard to all the characteristics necessary for the diagnosis of their cases. Therefore at present no precise statement can be made about the actual prognosis of Ewing's Sarcoma. But very likely it is even worse than has been generally assumed uptill now.

Zusammenfassung

Bei Studium der seit 1938 über das Ewing-Sarkom erschienenen Literatur stößt man auf die verschiedensten Angaben bezüglich der 5 Jahres-Überlebensraten. Die Ursache für die unterschiedliche Beurteilung der Prognose des Tumors ist in Diskrepanzen in der histologischen Diagnose zu suchen. Es werden die möglichen Fehlerquellen in der morphologischen Beschreibung des Ewing-Sarkoms — unter besonderer Wertlegung auf den negativen Ausfall der Gitterfaserfärbung und auf den positiven Glykogennachweis — aufgezeigt. Grundlage für die Kritik an zu hohen Überlebensraten ist das Fehlen mancher der für die Erkennung des Ewing-Sarkoms unbedingt erforderlichen histologischen Kriterien des Tumors.

Nach Anlegung eines strengen Maßstabes zeigt sich, daß kaum eine Statistik oder Kasuistik alle notwendigen Charakteristika zur Diagnose ihrer Fälle berücksichtigt. Aus diesem Grunde kann zur Zeit noch keine sichere Aussage über die tatsächliche Lebenserwartung beim Ewing-Sarkom gemacht werden. Höchstwahrscheinlich ist die Prognose jedoch noch schlechter, als bisher angenommen worden ist.

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  1. Wiener Knochengeschwulstregister am Pathologisch-Anatomischen Institut der Universität Wien und Orthopädische Universitätsklinik, Austria

    M. Salzer-Kuntschik & M. Wunderlich

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  1. M. Salzer-Kuntschik
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  2. M. Wunderlich
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Salzer-Kuntschik, M., Wunderlich, M. Das Ewing-Sarkom in der Literatur: Kritische Studien zur histomorphologischen Definition und zur Prognose. Arch orthop Unfall-Chir 71, 297–306 (1971). https://doi.org/10.1007/BF00417366

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