Our study’s major limitation is the retrospective design. Given
this limitation, our results should be validated by a larger, multidisciplinary,
prospective trial including children, adolescents, and
adults. In summary, adults with ES treated with modern chemotherapy
and local control measures in our cohort had prognostic
factors and outcomes similar to adolescents with ES. Dose-escalation
in the setting of positive margins may be considered in this
population. We recommend that treatment of all adults with ES
should consist of an aggressive, multidisciplinary approach to
achieve optimal outcomes.